11611 AIRPORT RD 2022-01-11 - Laserfiche WebLink

NENwit BIPILDING PERMIT APPLICATPN 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 11611 Airport Road PARCEL#: 00537900005300 CITY Everett STATE WA ZIP 98204 SUITE/UNIT#: 204 FLOOR#: 2 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Simutech/Mietzner Business Park LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Mietzner Business Park, LLC OWNER MAILING ADDRESS: STREET 11611 Airport Road, Suite B1 CITY Everett STATE WA ZIP 98204 OWNER PHONE:425-212-2490 OWNER EMAIL: jeffm@mietznergroup.com CONTRACTOR COMPANY NAME:Mietzner Brothers Properties, LLC , r , WA STATE CONTRACTOR LICENSE#(REQUIRED):mietzbp878cj CITY OF EVERETT BUSINESS LICENSE#(REQUIR b): application pending r CONTRACTOR ADDRESS: STREET 11611 Airport Road, Suite B1 ( if* ft 3 CITY Everett STATE WA ZIP 204 ( fCJ CONTRACTOR PHONE:425-212-2490 CONTRACTOR EMAIL:jeffm@mietznergroup.com ff PRIMARY CONTACT: El OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-754-9653 Jeff letz pr CONTACT EMAIL:jeffm@mietznergroup.com BUILDING INFORMATION VALUATION OF K:$37350.00 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall incl e the prevailing fair market valu f all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING US OF BUILDING:Offlc PROPOSED E OF BUILDIN . ffice HEAT SOURC . i]G ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ENew 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 EPool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Move 2 walls and add 1 wall for tenant. See drawing. 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.I am 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 # 3/15/21 P I� �,�� w Owner/Authorized Agent Signature Date (Revised 2/8/2021)