1410 SEINER DR SOUTH FORK BAKING COMPANY 2025-08-05

• • BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL 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)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1410 Seiner Drive PARCEL#: c in, Everett STATE WA ZIp 98201 SUITE/UNIT#: 103 FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):South Fork Baking Company LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Port of Everett OWNER MAILING ADDRESS: STREET 1205 Craftsman Way, Suite 200 cITY Everett STATE WA zip 98201 OWNER PHONE:425-259-3164 OWNER EMAIL: CONTRACTOR COMPANY NAME:Burton Construction, Inc. 5.3.3 WA STATE CONTRACTOR LICENSE#(REQUIRED):BURTOCI038MZ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 601 7954579 CONTRACTOR ADDRESS: STREET3915 E Nebraska Ave CITY Spokane STATE WA ZIP 99217 CONTRACTOR PHONE:425-213-9889 CONTRACTOR EMAIL: PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-508-6627 Brandon Whitaker CONTACT EMAIL:bwhitaker@portofeverett.com BUILDING INFORMATION VALUATION OF WORK: $500,000 ASSOCIATED LAND USE PROJECT#(if applicable):SMA#16-01 1 (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:New construction, no use currently in this tenant space PROPOSED USE OF BUILDING:This tenant space is planned to be used as a bakery and fine pastry establishment HEAT SOURCE: ❑✓Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ENew Construction ❑Addition ❑Remodel ❑Repair ❑✓T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ElTank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Tenant improvements work for future South Fork Bakery tenant. Work will include installing stub-ups for future fixtures under different permit, concrete slab, HVAC units installation and ducting, building the demising and interior partition walls, and electrical. 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 Fog_ PERMIT# ?/O —O9( oyez OF (e 9i27i22 ` Owner/Authorized Agent Signature Date (Revised 2/8/2021)