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MINIM <br /> rz 13131LDING PERMIT APPLICAI !UN IECEOVEI, <br /> EVERETT CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS:See a licable submittal checklist for submittal re uirements anr t ie1 rf r revii.!WASHINGTON then drop off completed application plus all required submittal documents to 3200 Ceet 2nd Floor nfa "Drop BL <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov I(W)e ov(permits <br /> (Blue or Black ink Only Please) PROJECT SITE INFORMATION 1 ` ~�°�� <br /> Pecrn:t .)CUViCC3 <br /> PROJECT SITE ADDRESS: STREET 1302 SE Everett Mall Way PARCEL#: 28051800402400 <br /> cm/ Everett STATE WA ZIP 92802 <br /> SUITE/UNIT#: 102 FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Trader Joe's <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Kyle God at <br /> OWNER MAILING ADDRESS: STREET 120 S. Sierra Ave. <br /> cr,, Solana Beach STATE CA ZIP 92075 <br /> OWNER PHONE:858-380-4053 OWNER EMAIL: kgodat@brixtoncapital.com <br /> CONTRACTOR COMPANY NAME:J. Hughes Construction, Inc. <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):JHUGHC1051 P6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57185 <br /> CONTRACTOR ADDRESS: STREET 312 173RD. Place SW <br /> CITY Bothell STATE WA zip 98012 <br /> CONTRACTOR PHONE:425-745-6341 CONTRACTOR EMAIL:toddm@jhughesconstructioninc.com <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Agent <br /> CONTACT NAME: CONTACT PHONE:727.346.5509/626-375-7413 <br /> Richard Burg/Dago Barajas CONTACT EMAIL:richbur us ermit.net/dago@jedadesigns.com g@ p g @jedadesigns.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $600,000.00 ASSOCIATED LAND USE PROJECT#(if applicable): <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:retail <br /> PROPOSED USE OF BUILDING:retail <br /> HEAT SOURCE: ❑✓Gas ❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑✓T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ETank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: <br /> Remodel of an existing 13,223 s.f. area, work to include, new interior walls, <br /> refrigeration equipment, new fixtures for a grocery store, new T-bar ceiling and lights, <br /> new HVAC distribution, new bathrooms and accessory offices for a grocery store. <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 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. <br /> and I comply with the State Contractors 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ��/ / �� PERMIT# t 0 <br /> b`/ <br /> Own A [zed Agent Signature Date (Revised 4/21/2022) <br />