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Nom <br /> BUILDING PERMIT APPLICATIUMI <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON 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 I(E)PermitServices©everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 8417 Evergreen Way PARCEL#: 28041300104900 <br /> CITY Everett STATE WA ZIP 98208 <br /> SUITE/UNIT#: 3 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Mochinut Everett <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: "'", ""''''ti s''.,,p Lot No: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Thomas&Anh Nguyen <br /> OWNER MAILING ADDRESS: STREET 9031 21ST AVE SW <br /> CITY Seattle STATE WA zip 98106 <br /> OWNER PHONE:510.759.8881; 206.465.3208 OWNER EMAIL: THOMASN73@GMAIL.COM;TINAHUONGANH@YAHOO.COM <br /> CONTRACTOR COMPANY NAME: Lee's Home Remodel <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): LEESHHR865N2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): lo( f 1 3 <br /> CONTRACTOR ADDRESS: STREET1123 10TH ST APT 13 <br /> cr r MARYSVILLE STATE WA ZIP 98270 <br /> CONTRACTOR PHONE:360.567.9442 CONTRACTOR EMAIL:vallnylee6l©gmall.Com <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Agent <br /> CONTACT NAME: CONTACT PHONE:206.322.4323 <br /> Nos N a ri n CONTACT EMAIL:permit@catchstudio.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $418,000 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: B-Restaurant <br /> PROPOSED USE OF BUILDING:B-Restaurant <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 ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:INITIAL BUILD OUT COMPLETING THE INTERIOR SPACE FROM VACANT RETAIL <br /> INTO NEW MOCHINUT (B-RESTAURANT). INTERIOR ALTERATIONS TO INCLUDE <br /> NEW FINISHES AND COMMERCIAL KITCHEN EQUIPMENT PER PLAN. <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 Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 42 <br /> � y 09.19.23 PERMIT# 07 <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />