5700 23RD DR W BLDG B 2025-11-07

BUILDiI4G PERMIT APPLICATION 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 5700 23rd Drive West PARCEL#: 28040200200800&28040200200801 cny Everett STATE WA zlp 98203 SUITE/UNIT#: Fj FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Northshore Christian Academy LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Northshore Christian Academy OWNER MAILING ADDRESS: STREET 5700 23rd Drive West CITY Everett STATE WA Zlp 98203 OWNER PHONE:425-407-1119 OWNER EMAIL: drichards@northshorechristian.org CONTRACTOR COMPANY NAME:Kirtley-Cole Associates LLC WA STATE CONTRACTOR LICENSE#(REQUIRED): IRl-14�g570G CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 45S CONTRACTOR ADDRESS: STREET2820 Oakes Ste B CITr Everett STATE WA ZIP 98201 CONTRACTOR PHONE:425-609-0400 CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect CONTACT NAME: CONTACT PHONE:425-252-2153 Todd Bullock CONTACT EMAIL:todd@2812architecture.com BUILDING INFORMATION VALUATION OF WORK:$185,175.00 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:Educational PROPOSED USE OF BUILDING:Educational 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: Tenant improvement of renovating and dividing an existing multipurpose room into two ELC classrooms, a storage room, and an office. RTTvJAnN 2 9 2CO22p4CCTTT ACKNOWLEDGEMENT.•1 have reviewed this application and confirm the information contained herein is true and correct.Work donjCPSI t tQlis,�rrrYii�oli3tfc TPT with current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations mu hPIP��ci�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 t" h application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Digitally signed by Todd Bullock PERMIT# Todd B u I I o ck Date:2024.01.26 12:05:23-08'00' 01/26/2024 I r _ O? D Owner/Authorized Agent Signature Date (Revised 412112022) `C