1302 BROADWAY THE BODEGA ON BROADWAY 2025-04-11

ra BDING PERMIT APPLICAN 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 1302 Notroadway PARCEL#: 00547425003100 c ITY Everett ,,-...ift WA ZIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):The Bodega on Broadway LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Brian Park OWNER MAILING ADDRESS: STREET 12730 Marine Drive CITY Marysville - E WA „- 98271 OWNER PHONE:(425) 772 - 8068 OWNER EMAIL: bcxpark@gmail.com • CONTRACTOR COMPANY NAME:TBD H 0 YygQ, yi i-At V-AIL t o Pk t► &c-k"1 Oh LN W pi rot,,4Es C0v s tcMa0 WA STATE CONTRACTOR LICENSE#(REQUIRED):N0 PT R pc .0 iv/CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): mit r} '24- CONTRACTOR ADDRESS: STREET CITY STATE SIR CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ✓❑OTHER(Please Specify) architect CONTACT NAME: CONTACT PHONE:206 384 3317 Benny Kim CONTACT EMAIL:bennykimdesign@outlook.com BUILDING INFORMATION VALUATION OF WORK: $200,000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall:nclude the prevailing fair market value of all labor,materials,and equipment needed to complete the work,wnether actually paid or not.) EXISTING USE OF BUILDING:Retail (Seven Eleven convenience store) 'PROPOSED USE OF BUILDING:Retail (grocery store) HEAT SOURCE: ❑✓Cas ❑Electric ❑Other tl BUILDING TYPE: USER ❑Townhouse ❑Duplex ❑ADU EMulti-Family-#Units: ©Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair l lT.I. ❑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: tenant improvement for a new grocery store in an existing convenience store. the work include minor demolition of non structural walls. build new partitions, add equipment and bathrooms and deli kitchen. ' ECEOVED(� al NOV 0 6 2023 ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work do � r r i RE,ToTiply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviation rst, e. u nz019, g 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 pe �t k'N lication is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. II City of Everett Official Use Only 10/30/2023 PERMIT ��r I —0 ( 0 Owner/Authorized Agent SignatureDam (Revised 4/21/2022)