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Bl' )ING PERMIT APPLICATI <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT U <br /> SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to3200 CeditriStrentTnd'.:Fbgr Intake Drop Box. <br /> CONTACT INFORMATION: (P)425-257-8810 1(E)PermitServices@everettwa:gov I(W)everet w gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION ; '- <br /> PROJECT SITE ADDRESS: STREET 1517 132nd St SE PARCEL#: portiorV of 97-i0078s-003 <br /> CITY Everett STATE WA zip 98208 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Chase Bank <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: Lot 2 (attach copy of long legal description) <br /> - r, CONTACT INFORMATION <br /> OWNER NAME:Chase Bank <br /> OWNER MAILING ADDRESS: STREET 10 South Dearborn Fir 13 <br /> CITY Chicago STATE IL ZIP 60603-5506 <br /> OWNER PHONE:872.400.0071 OWNER EMAIL: Theodore.Foggy@Chase.com <br /> CONTRACTOR COMPANY NAME: _r -, IvS?.eer. c <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED) N I, ((P•i.V ) CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 66-62( <br /> CONTRACTOR ADDRESS: STREET 5"6 g 6 S E 6,2NP bRI i V'/1e <br /> CITY G -,l}CKA./I V/I� STATE O� ZIP 9 / o 5�' <br /> CONTRACTOR PHONE: 5�3-v'.S 7 C�3o!3 CONTRACTOR EMAIL: - I M 5(Q ' /�t c r CL /VI <br /> PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:360.818.7004 <br /> Chuck Dougherty CONTACT EMAIL:CDougherty@PMDGinc.com <br /> Op��yy BUILDING INFORMATION <br /> VALUATION OF WORK: $ 'gam"30b/ goo. c3 ASSOCIATED LAND USE PROJECT#(if applicable): EA-PP023•'d I`lU <br /> (Valuation shall include the prevailing fair market value of alflabor,materials,and equipment needed to complete the work,whether actually paid or not.) (� <br /> EXISTING USE OF BUILDING:New construction 1 k.) , .3 003 <br /> PROPOSED USE OF BUILDING:Retail Bank <br /> HEAT SOURCE: ❑✓Gas ❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑✓New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: CONSTRUCTION OF 2,700 S.F. ONE STORY CHASE BANK BUILDING INCLUDING TENANT <br /> IMPROVEMENTS FOR NEW INTERIOR SPACE DESIGN WITH MECHANICAL, PLUMBING, <br /> ELECTRICAL SCOPE. <br /> • SITE WORK TO INCLUDE PAVED PARKING AREA, LIGHT POLES, CONCRETE SIDEWALKS <br /> AND PAD FOR DRIVE-UP ATM AND CANOPY. CONNECTING TO EXISTING UTILITIES. <br /> • REMODEL OF EXISTING LANDSCAPING & IRRIGATION. <br /> • SIGNAGE AND DRIVE-UP CANOPY BY SIGN VENDOR. <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Digitally signed by Chuck Dougherty _ PERMIT# /` 'Y1 ///---��� <br /> Chuck Dougherty Date:2023 5.I9 10:45:09 0'ODougheoy O PM O/ / { <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) (�/lam IIJ/ <br />