1302 BROADWAY THE BODEGA ON BROADWAY 2025-04-11

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, wA<NINGTON 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 ( (E) PermitServices(@everettwa.gov I (W) eve.rettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET yoadkV PARCEL #: S 3100 CITY Evereff STATE WA ZIP SUITE/UNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION (If applicable): TENANTBUSINESS NAME (if non-residential): TheGooleaa on f3y-cadwaq LEGAL DESCRIPTION for new construction Short Plat/subdivision Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: SrfaA Park - OWNER MAILING ADDRESS: STREET Q Mu kl f0 give/ CITYyeyef STATE ZIP o3 OWNER PHONE: (4-25) 77 - 8C)6I6 OWNER EMAIL: bc,)Cpark=�@gmetil.com CONTRACTOR COMPANY NAME:New &retna Inc. WA STATE CONTRACTOR LICENSE #(REQUIRED):CC ME WrafaCITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 580 CONTRACTOR ADDRESS: STREET 5051 14+ 5f 5W cm O STATE WA ZIP P 02 /S CONTRACTOR PHONE: C CONTRACTOR EMAIL: P V22Yi 1 1cow PRIMARY CONTACT: KOWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) . CONTACT NAME: 9Yia✓i Pavk CONTACT PHONE: 4.2s) r7r72 — 806 CONTACT EMAIL: box yt "C I• Com BUILDING INFORMATION VALUATION OF WORK: $ Soo, ow . 00 1ASSOCIATED LAND USE PROJECT # (if applicable): Waluawr 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: aeiai k C 9 -1 I C Oh V ievi S t bye PROPOSED USE OF BUILDING: I C Y U shv HEAT SOURCE: ❑Gas lectric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU []Multi -Family - # Units ommercial ❑Accessory Structure TYPE OF PROJECT (check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair AT1. ❑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: UPdatin9 CW1+f .thy 1►Avwt4d-ron fur - ZS I I - 010 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 # '7/3o/2D24 Owner/Authorized Agent Signature Date (Revised 4,2112022)