1410 SEINER DR SOUTH FORK BAKING COMPANY 2025-08-05

BO_ AIL Ira DING PERMIT APPLICA EVERETT CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHItr6GTON) 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)PermitServices@everettwa_gov I('Al)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1410 Seiner Drive PARCEL#: 29051800402200 crry Everett STATE WA zip 98201 SUITE/UNIT#: 103 FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential):South Fork Baking Company, LLC LEGAL DESCRIPTION for new construction: Short Plat/subdivision: (see attached) Lot No.: LOT Al2 (attach copy of long legal description) _ CONTACT INFORMATION OWNER NAME:Katherine Hillmann OWNER MAILING ADDRESS: STREET 1711 Colby Ave cny Everett STATE WA ZIP 98201 OWNER PHONE:425-879-2679 OWNER EMAIL: southforkbakingco@gmail.com CONTRACTOR COMPANY NAME:Tapert Ventures LLC DBA:CPM:Tenant Improvement Solutions WA STATE CONTRACTOR LICENSE#(REQUIRED):CC COMMEPM784KF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 64698 CONTRACTOR ADDRESS: STREET 1509 Bonneville Ave,Suite A cny Snohomish STATE WA ZIP 98290 CONTRACTOR PHONE:360-863-6705 CONTRACTOR EMAIL:ryan@cpmnw.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-863-6705 Ryan Tapert I Dir.of Pre-Construction CONTACT EMAIL:ryan@cpmnw.com, BUILDING INFORMATION t. VALUATION OF WORK:$100,000 (ASSOCIATED LAND USE PROJECT#(if applicabl0_, _ o 7 ) (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) em 1_ EXISTING USE OF BUILDING:N/A *- C/d/ PROPOSED USE OF BUILDING:Group B,Baked goods,cakes,and coffee cafe HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: DCommercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction DAddition ❑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) DOther. DESCRIPTION OF WORK:TENANT IMPROVEMENT OF A PROPOSED APPROX. 1,252 OVERALL SQ. FT. FOOD SERVICE SPACE WITHIN A PROPOSED MULTI-UNIT BUILDING ACKNOWLEDGEMENT:l 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 I am authorized by the owner of this property to perform the work for which application is made, and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# -wnerlA orized Agent Signature Date (Revised 4121/2022)