906 SE EVERETT MALL WAY MEDIX INFUSION 2025-09-29

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 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: STREET906 SE EVERETT MALL WAY. III PARCEL #: 28051800308500 ,Ty EVERETT STATE WA z,p 98208 SUITE/UNIT #: 400 FLOOR #:4 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential): MEDIX INFUSION LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:PJP 5, LLC OWNER MAILING ADDRESS: STREET 7525 SE 24TH STREET, SUITE 300 CITY MERCER ISLAND STATE WA ZIP 98040 OWNER PHONE:206-607-6021 1OWNER EMAIL: danny@pjpnW.001T1 CONTRACTOR COMPANY NAME:AVARA CONSTRUCTION WA STATE CONTRACTOR LICENSE #(REQUIRED): AVARAC1824BR CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 63222 CONTRACTOR ADDRESS: ITIEET15333 NE 90TH ST, SUITE 140 CITY REDMOND STATE WA ZIP 98052 CONTRACTOR PHONE:206-365-4440 1CONTRACTOR EMAIL:JCPISe @ aVaf aCOnStf UCtIOn.com PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑✓ OTHER (Please Specify) ARCHITECT CONTACT NAMEXEVIN BRODERICK CONTACT PHONE:206-682-7525 CONTACT EMAIL:keVln@brOderlCkarClllteCtS.COn1 BUILDING INFORMATION VALUATION OF WORK: $95,000 1ASSOCIATED 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:B-OFFICE PROPOSED USE OF BUILDING:NO CHANGE 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:INTERIOR OFFICE TENANT IMPROVEMENT ON THE 4TH FLOOR. SCOPE TO INCLUDE SELECTIVE DEMOLITION OF EXISTING WALLS TO CREATE A PASS THROUGH RECEPTION WINDOW. TWO NEW OFFICES WILL BE CREATED AND THE PREP ROOM ENLARGED. THE EXISTING SPACE WILL BE DEMISED TO CREATE A NEW TENANT SUITE (402). NO EXTERIOR WORK INCLUDED. NO CHANGE IN OCCUPANCY. 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 1 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. 77- —� -- 4- 11.26.24 Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT # (Revised 412112022)