2900 GRAND AVE SUMMIT EVERETT 2025-01-10

MILDING PERMIT APPLICA1N CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2900 GRAND AVENUE SPACE 4&5 PARCEL#: LOT 21&22 343.,302100_Or23&24.0439162602306101 25&26.043916290251 cny eVERETT STATE WA Zw 98201 SUITE/UNIT#: 4&5 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):SUMMIT EVERETT LEGAL DESCRIPTION for new construction: Short Plat/subdivision: EVERETT°LATOF,LK670ovo,LOTS 21THRU40 Lot No.:SEE BELOW (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:CH GRAND AVENUE LLC OWNER MAILING ADDRESS: STREET 236 W PORTAL AVE# 150 CITY SAN FRANCISCO STATE CA Zw 94127 OWNER PHONE:(415) 690-6442 OWNER EMAIL: HARRYARTHUR@CUMBERLANDHOLDINGS.COM CONTRACTOR COMPANY NAME:' T �� y WA STATE CONTRACTOR LICENSE#(REQUIRED): JL(. //E�t.j CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 67 CONTRACTOR ADDRESS: STREET Li..30 7 / /(7 i nf- /hie � ,(/J cm STATE V Zp CONTRACTOR PHONE: 5663 S'.�y,,(31,4 /c9..v CONTRACTOR EMAIL: ? 666 PRIMARY CONTACT: ❑OWNER E CONTRACTOR ❑✓ OTHER(Please Specify) ADAM CLARK(ARCHITECT) CONTACT NAME: CONTACT PHONE:(425) 252 2153 PAUL DOUGLAS (2812 ARCHITECTURE) CONTACT EMAIL:paul@2812architecture.com BUILDING INFORMATION VALUATION OF WORK: $300000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:bUSineSs PROPOSED USE OF BUILDING:bUSiness HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Comm,,r�cial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction EAddition Remodel ❑Repair E di 1. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:Open gym area to have Climbing walls installed. r-� � s �J[� ILt� (`�'�'JL� l� L� FEB 15 2024 :J CITY OF EVERETT Permit Ser;/icies 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# P * February 09th,2024 _-03/ Owner/AuthortefedAgent i'nature Date (Revised 4/21/2022)