10115 EVERGREEN WAY PEP BOYS 2025-04-14

BIDING 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 I (E)everetteps@everettwa.gov I (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 10115 Evergreen Way PARCEL#: 0013276 cITY Everett STATE WA zIP 98204 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):PEP BOYS MANNY MOE & JACK#528 LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:PEP BOYS MANNY MOE & JACK OWNER MAILING ADDRESS: STREET 3111 W Allegheny Ave CITY Philadelphia STATE PA ZIP 19132 OWNER PHONE:678-640-8419 OWNER EMAIL: prinston_moon@pepboys.cOm CONTRACTOR COMPANY NAME:TBD WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER (Please Specify) Project Manager CONTACT NAME: CONTACT PHONE:(312) 260-7074 Kevin McKenna CONTACT EMAIL:kmckenna@burnhamnationwide.com BUILDING INFORMATION VALUATION OF WORK: $312, 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:Existing Pep Boys location PROPOSED USE OF BUILDING:Pep Boys 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 tenant improvements to an existing Pep Boys location. Scope of work includes t h e ,Q,( c�CQ ��o�-�C v�v��, Aa-( ---(e i cre- t 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.1 ant the owner,or I 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. City of Everett Official Use Only (/ (/ 02/16/2022 PE _ �S Owner/Authorized Agent Signature Date (Revised 2/8/2021) )�