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1031 SE EVERETT MALL WAY MODERN DENTISTRY 2022-03-07
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1031 SE EVERETT MALL WAY MODERN DENTISTRY 2022-03-07
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Last modified
3/7/2022 3:38:07 PM
Creation date
10/18/2017 11:40:01 AM
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Address Document
Street Name
SE EVERETT MALL WAY
Street Number
1031
Tenant Name
MODERN DENTISTRY
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PERMIT APPLICATION <br />BUILDING 9ECHANICAL / PLUMBING / SIGN / 5 RINKLER / DEMOLITIO <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />OL (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 1 031 SE Everett Mail Way <br />1PROPERTY TAX #: 28051 800308300 <br />LEGAL for new construction: Short Plat/subdivision NE1/4 of the SW1/4 of sec 18 Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Everett Covenant Group TENANT NAME (If Commercial): TBD <br />OWNER MAILING ADDRESS: STREET 17000 Red Hill Ave <br />CITY Irvine STATE CA ZIP 92614 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NA E: tbd C- <br />L�- <br />CONTRACTOR AD <br />ES STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED7-.- <br />CITY OF EVERETT BUSINESS LICENSE #(REQUI D) <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR Z1 OTHER (Please Specify) Architect <br />CONTACT NAME: <br />Julie A. Margetich <br />CONTACT PHONE: 951-582-5745 <br />CONTACT EMAIL: margetichj@pacden.com <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Office <br />Contract Price of Work: $ 148,000 <br />Proposed Use of Building: Multi Tenant- Dental Office & Retail/Food <br />Heat Source: OGas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi -Family-# of Units: OCommercial ❑Industrial <br />Type of Project: El New ❑Addition ORemodel ❑Repair OT.I. ❑Sign ❑Sprinkler 9]Demolition VlChange of Use <br />DESCRIPTION OF WORK: <br />fVew-p Alit building for multi -tenants, build out 2,700 s,f, dental office tenant improvement. add landscape planters <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _ Addn _Alteration <br />_Repair <br />Type of Project: _New _Addn <br />_Alteration _Repair <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C - Air Handling Units <br />Heat Pump <br />Toilet <br />Ba w Preventer (Inside Bldg) <br />Forced Air SXstenns <br />U2it Heater <br />Bathtub <br />10rinal <br />Gas Piping <br />Boiler <br />Lavatory (Wa Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />Wood Stove <br />Kitchen Sink & DilaposaK <br />Grease Trap <br />Gas Range <br />Ducting <br />Dishwasher <br />Roof Drains <br />Clothes Dryer Hoo'Wps <br />Other: <br />Clothes Washv <br />Medical Gas <br />Range Hood <br />Water Hea <br />Other: <br />Exhaust Fart <br />Sink (S ice/Bar/Mop/etc.) <br />10ther. <br />SPRINKLER <br />/ SUPPRESSION <br />SYSTEM <br />Number of Heads <br />ACKNOWLEDGEMENT: 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br />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 <br />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, <br />and / comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />J" 3�=-Q <br />Signature Date <br />City of Everett Official Use Only <br />P IT # <br />2- <br />(Revised 912312016) <br />
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