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Limm BUDING PERMIT APPLICATIeI l ECEIVE , <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirement nd n�r cf p ��Rquired of eview, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 0 Ced e d I6�i�dlntak r p Box. <br /> CONTACT INFORMATION: (P)425-257-8810 I (E)PermitServices@everettwa.gov ( everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION 1 Y OF E`°°ERE , <br /> Permit Larvit, , <br /> PROJECT SITE ADDRESS: STREET 305 SE Everett Mall Way Suite#14 PARCEL#: <br /> CITY Everett STATE WA ZIP 98208 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Bath and Body Works <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Pacific Asset Advisors, Inc <br /> OWNER MAILING ADDRESS: STREET 14205 SE 36th Street Suite 215 <br /> CITY Bellevue STATE WA ZIP 98006 <br /> OWNER PHONE:425-990-6200 x 112 OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:To be Determined rime CAL, f eytS tn cA- Pn !t7 r✓ <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): ?1,0 S (S..' 3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):v- t 2.0 .3 <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Authorized Agent <br /> CONTACT NAME: CONTACT PHONE:469-897-5897 <br /> Sarah O ke rst ro m CONTACT EMAIL:sokerstrom@cdsdevelopment.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $70,000 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:Mercantile <br /> PROPOSED USE OF BUILDING:Mercantile <br /> HEAT SOURCE: ❑Gas ❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi Family-#Units: E iCommercial ❑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:Temporary retail space for Bath & Body Works. The tenant space will not be redemised or modified from <br /> the current footprint and square footage. All plumbing connections are existing to remain. Kitchen sink will <br /> be replaced. No modifications to the HVAC system. Minor modifications are to be made fort he relocation <br /> of an existing cashwrap. No exterior work apart from a Bath and Body Works sign. Majority of the work will <br /> be cosmetic. A new demonstration sink will be added to the space, existing plumbing will be used to serve <br /> this. One wall will be partially removed to open up the sales area. Existing offices will be connected and <br /> made into one storage area by removing doors, closing openings and creating new wall openings. <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 /> c�'G'v2 G (31,2A, 29yyt. 4/4/2023 PERMIT# �� L <br /> r <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />