3322 BROADWAY COMPASS HEALTH 2025-10-03

BU- DING PERMIT APPLICATY"N EVERETT CITY OF EVERETT PERMIT SERVICES SUBMITTAL 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 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 3327 Lombard Ave. PARCEL #: 00439079501500 CITY Everett STATE WA ZIP 98201 SUITE/UNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential): Compass Health Parking Lot LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Compass Health OWNER MAILING ADDRESS: STREET 4526 Federal Ave. CITY Everett STATE WA ZIP 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME: BNBuilders ��' I -� GG WA STATE CONTRACTOR LICENSE #(REQUIRED):-@02G5SeS�'- CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 43638 CONTRACTOR ADDRESS: STREET2601 4th Ave, Suite 350 CITY Seattle STATE WA ZIP 98121 CONTRACTOR PHONE:206.382.3443 CONTRACTOR EMAIL:Iosh.erickson@bnbuilders.com PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Josh Erickson CONTACT PHONE: Josh Erickson CONTACT EMAIL:josh.erickson@bnbuiIders.com BUILDING INFORMATION VALUATION OF WORK: $ C 92 _ -`'{ ASSOCIATED LAND USE PROJECT # (if applicable): PW2203-002 (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: Parking Lot PROPOSED USE OF BUILDING: Temp office trailers in the parking lot. 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 ❑Remodel ❑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: Two temporary construction office trailers to support the new Compass Health project at 3322 Broadway. Blocked and tied down per details. OSHA stairs at each door. D EC IEUVE SEP 16 2023 ACKNOWLEDGEMENT: i have reviewed this application and confirm the information contained herein is true and correct. Work C4eTpYr.QlftovhrS/pelRtmlttTomply with current federal, state, and focal law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations aei;tfMJte8�griting from the Building Official before being authorized under any circumstance. 1 am the owner, or I am authorized by the owner of this property to perform the wor for w rcii application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Owner/Autk}vfiized Agent Signature City of Everett Official Use Only � PERMIT # '�{'')�7��—.,\( '�} /l.�' L I? - 3 V I Date(Revised 412112022)