10521 19TH AVE SE ALLIED TELESIS INC 2025-01-28

NEN BI DING PERMIT APPLICAT- N 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 10521 19th Ave SE PARCEL#: 28052000203000 CITY Everett STATE WA ZIP 9820 SUITE/UNIT#: FLOOR#: 1 ADDITIONAL LOCATION/�'� INFORMATION (if applicable): VV TENANT/BUSINESS NAME(if non-residential) TA Ll, /O[� i''Co_.> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Allied Telesis OWNER MAILING ADDRESS: STREET 19800 N Creek Pkwy#100 CITY Bothell STATE WA ZIP 98011 OWNER PHONE:425.487.8880 OWNER EMAIL: doug_barga@alliedtelesis.com CONTRACTOR COMPANY NAME:HST Construction WA STATE CONTRACTOR LICENSE#(REQUIRED):HSTCOC1920KA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 050794 CONTRACTOR ADDRESS: STREET 11512 NE 20th St CITY Bellevue STATE WA ZIP 98004 CONTRACTOR PHONE:425.681.4326 CONTRACTOR EMAIL:nigelstarr@hstconstruction.com PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect CONTACT NAME: CONTACT PHONE:360.420.7233 Emily Van Dyke CONTACT EMAIL:emilyvd@jpcarchitects.com BUILDING INFORMATION VALUATION OF WORK: $436,485.43 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:Retail/Office PROPOSED USE OF BUILDING:Retail/Office HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: LISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.l. ❑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:Landlord Upgrades DESCRIPTION OF WORK:SEBC AREA OF WORK ALTERATION LEVEL 2 PER SECTION 603. INTERIOR ONLY, NON STRUCTURAL CONSTRUCTION OF NEW GWB/TAPE ON EXISTING WALLS AND CONCRETE PATCHING. 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 4.7.2023 PERMIT# r G� OwnerlAuthorizol Agent Signature Date (Revised 4/21/2022)