6202 ASSOCIATED BLVD 2021-10-12 - Laserfiche WebLink

NMI EIPILDING PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINOTON 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 6202 Associated Blvd PARCEL#• 28040100302300 CITY Everett STATE WA zip 98203 SUITE/UNIT#: FLOOR#: t ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Jacob Davis OWNER MAILING ADDRESS: STREET 10600 231st Way NE CITY Redmomd STATE WA ZIP 98053 OWNER PHONE: OWNER EMAIL: 1•davis@fanaco.com CONTRACTOR COMPANY NAME:1 V WA STATE CONTRACTOR LICENSE#(REQUIRED C.L 'C 1q(q 1C 1 OF EVERETT BUSINESS UCENSE#(REQUIRED):LICin3 CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ©OTHER(Please Specify) SynThesia Architects CONTACT NAME: CONTACT PHONE:425-417-8352 John L I a c u n a CONTACT EMAIL:John.Llacuna@SynThesisPLLC.com BUILDING INFORMATION VALUATION OF WORK:$135,000 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:NA PROPOSED USE OF•BUILDING:Warehouse and Office 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:Construction of new offices and demising wall within an existing tilt-up industrial shell. 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 e 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!comply with •-State ontractors Law 18.27 RCW and 298.200A WAC City of Everett Official Use Only PER� � .✓ . 3 - a��-/ 2�3_ o S6 Owner/Aut r-d • .=atSignature ate (Revised 2/8/2021)