8530 EVERGREEN WAY FRED MEYER 2025-04-14

E B!ILDING PERMIT APPLICAAN 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 8530 Evergreen Way PARCEL#: 28041300100800 cm, Everett STATE WA zip 98208 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Fred Meyer LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Fred Meyer Stores, Inc. OWNER MAILING ADDRESS: STREET 3800 SE 22nd Ave CITY Portland STATE Oregon ZIP 97202 OWNER PHONE:503.797.7439 OWNER EMAIL: dean.uriarte@fredmeyer.com fredmeyer.com CONTRACTOR COMPANY NAME:Green Way Construction LLC cj(G L 4- WA STATE CONTRACTOR LICENSE#(REQUIRED):GREENWC939R0 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54-i t] CONTRACTOR ADDRESS: sTREET8295 NE Evergreen Pkwy#205 cITy Hillsboro STATE Oregon ZIP 97124 CONTRACTOR PHONE:503.762.1922 CONTRACTOR EMAIL:kelthp@greenway-IIc.com PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect CONTACT NAME: CONTACT PHONE:503.329.7448 Randy Trout/ArchiTrout Design&Architecture CONTACT EMAIL:randy@architrout.com BUILDING INFORMATION VALUATION OF WORK:$40,000 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:Mercantile - Retail PROPOSED USE OF BUILDING:Mercantile - Retail HEAT SOURCE: ❑Gas ❑Electric ❑Other existing BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ✓❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑✓Remodel ❑Repair ETA. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ETank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:Addition of customer flow control gates and rails at entries. 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 1 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 141A t�tzl23 PERMIT# �j '� O ) - 033 Ow Authorize A g ture Date (Revised 4/21/2022) y