1605 SE EVERETT MALL WAY WALMART 2025-09-10

BUIP `)ING PERMIT APPLICATIC"'i L C�L pML CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal re uirem and �er ofl1ccgqir� ,require f review, WASHINGTON then drop off completed application plus all required submittal documents to Ced�a�r?�Street zn( loor Inta op Box. CONTACT INFORMATION: (P)425-257-8810 1 (E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATIONEVERETT PROJECT SITE ADDRESS: STREET 1605 SE Everett Mall Way PARCEL#: 280518 0144 ervlces CITY Everett STATE WA zIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Walmart Real Estate Business Trust OWNER MAILING ADDRESS: STREET 2914 SE I St CITY Bentonville STATE AR ZIP 72712 OWNER PHONE:479.273.4000 1OWNNEERpEMAIL: kristen.dingerlQ@Walmart.com CONTRACTOR COMPANY NAME:T d61A)M Q-C/.L) .�I r`U� N C - WA STATE CONTRACTOR LICENSE#(REQUIRED): � G/ �,S! �I+ ITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET E �—Dyt(S W'ib� CITYlttIi�%( STATE :;! ZIP CONTRACTOR PHONE: —2 —304f 0 CONTRACTOR EMAIL: gM(414,4 d eS(CeNt-fYt�c �oiy. PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) Agent CONTACT NAME: CONTACT PHONE:479.278.2792 Letetia Carter CONTACT EMAIL:Ietetia.carter@pb2ae.com BUILDING INFORMATION VALUATION OF WORK:$1,500,000 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 PROPOSED USE OF BUILDING:Mercantile HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial []Accessory Structure TYPE OF PROJECT(check all that apply): ❑New,Construction ❑Addition ZRemodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Remodel of Walmart 3053 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./am the owner, or/am authorized by the owner of this property to perform the work for which application is made, and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Digitally signed by Letetia Carter DN:cn=Letetia Carter,o,ou, Letetia Carter email=letefia.carter@pb2ae.com, rE�� !— c=us 03.06.2023 l�� IJ Date:2023.03.06 11:10:66-06'00' Owner/Authorized Agent Signature Date (Revised 412112022)