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r <br />EVERETT <br />WASHINGTON <br />Bt"'.DING PERMIT APPLICAT'"`N <br />CITY OF EVERETT PERMIT SERVICES <br />SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br />then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br />CONTACT INFORMATION: (P) 425.257.8810 1 (E) everetteps@everettwa.gov I (W) everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: STREET 1000 SE EVERETT MALL WAY PARCEL #: 28051800305400 <br />CITY EVERETT STATE WA ZIP 98208.2814 <br />SUITE/UNIT #: #110 8 #410 FLOOR #: 1st & 4th ADDITIONAL LOCATION INFORMATION (if applicable): <br />TENANT/BUSINESS NAME (if non-residential): LWA00310 Everett USFS <br />LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: COLLIERS INTERNATIONAL <br />OWNER MAILING ADDRESS: STREET 601 UNION STREET, SUITE 5300 <br />CITY Seattle STATE WA ZIP 98101 <br />OWNER PHONE.206-223-1262 <br />OWNER EMAIL: vanessa.magnuson@colliers.com <br />CONTRACTOR COMPANY NAME: +3ft" J7f , R 5' i ' 't?) /�- A) T- I20VeS <br />WA STATE CONTRACTOR LICENSE #(REQUIRED):F-AKVVET16%t4 <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): C/ o <br />S �S�-/ <br />CONTRACTOR ADDRESS: STREET P U QO 79 S <br />CITY Eb M.!,-)A }, S ��ST""ATE � ZIP <br />CONTRACTOR PHONE: -- 7S 5 — ��3 D CONTRACTOR EMAIL: Tom) <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑✓ OTHER (Please Specify) WARE MALCOMB(ARCHITECTS) <br />CONTACT NAME: <br />Cindy Kang / Kate Wlttenbrook - Horne <br />CONTACT PHONE: Cindy: 425-582-5503 / Kate: 425-582-5505 <br />CONTACT EMAIL: ckang@waremalcomb.com / katew@waremalcomb.com <br />BUILDING INFORMATION <br />VALUATION OF WORK: $ $700,000.00 <br />ASSOCIATED LAND USE JECT--# (if applicable): U S- DI o <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: OFFICE/B <br />PROPOSED USE OF BUILDING: OFFICE/B <br />HEAT SOURCE: ❑Gas ❑Electric ❑Other <br />BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: DCommevUal ❑Accessory Structure <br />TYPE OF PROJECT (check all that apply) : ❑New Construction ❑Addition ❑Remodel ❑Repair RrT.I. ❑Change of Use <br />❑Modular ❑Portable ❑Re -roof ❑Exterior Alteration ❑Tank (above ground) ❑Accessory Structure <br />CFence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank (above ground) ❑Other: <br />DESCRIPTION OF WORK: The scope of this project includes the First (1st) & Fourth (4th) floors tenant Improvement of an existing <br />office spaces for use of the same. The First floor construction includes demolition of walls, doors, ceiling, <br />lighting, and finishes to create (3) separate suites and a new accessible restroom. The fourth floor is <br />taking the existing suite #410 and expanding into suite #420. Construction includes demolition of walls, <br />doors, ceiling, lighting, and finishes. New construction to include new partition walls, doors, ceiling, <br />lighting, and finishes. <br />Exterior scope: creating a secured fenced in parking area within an existing parking lot. Existing striping to <br />remain, provide new gate & gate operator and Chainlink fence with door. <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 tinder any circumstance. / am the owner, or / 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 />Kate WltenWook - Home - -+%?, .._.... .Pi•~,•..K a..., ���•�^ <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PERMIT # <br />(Revised 21812021) I/ <br />Z <br />