9900 19TH AVE SE WINCO FOODS 2025-04-21

imm am BUWING PERMIT APPLICATI, D 1©E1VE CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requiremetp s nd nuBtkpr or t pi quired eview, WASHINGTON then drop off completed application plus all required submittal documents to 3 edar Met 2rild hoor Intake p Box. CONTACT INFORMATION: (P)425-257-8810 I (E)PermitServices©everettwa.gov I (W)everettwa9ov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION CITY OF EVERETT Permit Scrviccs PROJECT SITE ADDRESS: STREET 9900 19TH Ave. se PARCEL#: 28051800405400 cITY Everett STATE WA ZIP 98208 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):WinCo Foods, LLC LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:WinCo Foods, LLC OWNER MAILING ADDRESS: STREET 650 N.Armstrong Place CITY Boise STATE ID ZIP 98208 OWNER PHONE:(208)377-0110 OWNER EMAIL: michael.tran@wincofoods.com CONTRACTOR COMPANY NAME:T t(WeleQjb '(x'j 'ij- WA STATE CONTRACTOR LICENSE#(RE : ,'V t'L54 SrITY OF EVERETT BUSINESS LICENSE#(REQUIRED)4 CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) owner's Agent CONTACT NAME: CONTACT PHONE:(208) 258-6155 Ryan Barnett CONTACT EMAIL:rbarnett@bhillsarch.com BUILDING INFORMATION VALUATION OF WORK: $60,000 ASSOCIATED LAND USE PROJECT#(if applicable):N/A (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:Grocery Retail/Merchantile PROPOSED USE OF BUILDING: HEAT SOURCE: ❑✓Gas EElectric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑✓Remodel ❑Repair ❑T.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: Demolish existing demising wall panels and concrete curb in bakery cooler/ freezer box. Trench 24" wide strip of concrete, install thermal break and new cooler box wall panels at demising wall. 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 06/06/2023 PERMIT# / (3--""-'-------- tc30 6 -- 032 Owner/Authorized Agent Signature Date (Revised 4/21/2022)