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I. E3111/LDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 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 to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425-257-88101(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SiTE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2614 Colby Ave PARCEL#: 00562461302500 <br /> CITY Everett STATE WA Zip 98201 <br /> SUITE/UNIT#: 2614-A FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): NORTH HALF OF THE PARCEL <br /> TENANT/BUSINESS NAME(if non-residential):Yomie's Rice Yogurt Everett LLC <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Zhixiong Liu <br /> OWNER MAILING ADDRESS: STREET 310 175TH PL SW <br /> CITY BOTHELL STATE WA Zip 98012 <br /> OWNER PHONE:(425)985-6668 OWNER EMAIL: xiong6668@yahoo.com <br /> CONTRACTOR COMPANY NAME:Newmark Construction LLC <br /> WA STATE CONTRACTOR LICENSE*REQUIRE.qtw iy C. 835➢ICiTY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62986 <br /> CONTRACTOR ADDRESS: STREET 5922 77th Dr NE <br /> CITY Marysville STATE WA zip 98270 <br /> CONTRACTOR PHONE:2063728668 CONTRACTOR EMAIL:jianzhitan714@gmail.com <br /> PRIMARY CONTACT: 0 OWNER E CONTRACTOR ©OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:206-466-1225 <br /> Zeyu Li CONTACT EMAIL:zyli@studiol9architects.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$30,000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not) <br /> EXISTING USE OF BUILDING:VACANT RETAIL SPACE <br /> PROPOSED USE OF BUILDING:YOGURT STORE/CAFE <br /> HEAT SOURCE: ❑Gas ©Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex EADU OMulti-Family-#Units: lZ Commercial []Accessory Structure <br /> TYPE OF PROJECT(check all that apply): DNew Construction ❑Addition ❑Remodel ❑Repair ©T.l. ❑Change of Use <br /> ❑Modular ❑Portable EIRe-roof ❑Exterior Alteration ETank(above ground) EAccessory Structure <br /> ❑Fence over 7ft high ❑RackStorage EPool/Hot Tub ElTank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: <br /> Tenant Improvement project to convert an existing vacant retail space into a yogurt <br /> shop with a small dining area and kitchen (no open flame cooking) <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.1 am the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 10/25/2022 PERMIT# (:;4:1 <br /> -en Li <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />