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B( DING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 6003 23RD DRIVE WEST PARCEL#: 28040200300800 <br /> cur EVERETT STATE WA zip 98203 <br /> SUITE/UNIT#: FLOOR#:2 ADDITIONAL LOCATION INFORMATION(if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):NetAllyNigilant <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: SEE ATTACHED Lot No.: SEE ATTACHED (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:BRANDON DION <br /> OWNER MAILING ADDRESS: STREET 6003 23RD DRIVE WEST <br /> CITY EVERETT STATE WA ZIP 98203 <br /> OWNER PHONE:503-620-1710 OWNER EMAIL: BrandonD@a Vigilant.org <br /> CONTRACTOR COMPANY NAME:KIRTLEY COLE <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):KIRTLAL951 BC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 42968 <br /> CONTRACTOR ADDRESS: sTREEr2820 OAKES AVE STE B <br /> cin, EVERETT STATE WA Zip 98201 <br /> CONTRACTOR PHONE:425-609-0400 CONTRACTOR EMAIL:JSChWartz Q' Kirtley-Cole.com <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑✓ OTHER(Please Specify) ARCHITECT <br /> CONTACT NAME: CONTACT PHONE:206-890-4175 <br /> Kate Stein, Dykeman Architects CONTACT EMAIL:kates@dykeman.net <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$ ISO'000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not) <br /> EXISTING USE OF BUILDING:BUSINESS <br /> PROPOSED USE OF BUILDING:BUSINESS <br /> HEAT SOURCE: ❑Gas ❑Electric DOther <br /> BUILDING TYPE: ❑SFR ElTownhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑✓T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof DExterior Alteration ❑Tank(above ground) ElAccessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other. <br /> DESCRIPTION OF WORK:5,623 SF T.I. INCLUDING PARTIAL DEMOLITION OF WALLS, DOORS, AND <br /> RELITES. RELOCATION OF (2) EXISTING LIGHT FIXTURES. DEMISING FLOOR 2 <br /> SF INTO (2) SEPARATE TENANT SUITES WITH COMMON CORRIDOR. NEW <br /> WALLS, DOORS, RELITES, WALL HEADERS, KITCHENETTE. <br /> A anD V Vigtai CatA(rdt 4u- ale fb cf•ea)l-e, <br /> ACKNOWLEDGEMENT:!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.lam the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 02/23/21 PE <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br /> Z <br />