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• <br /> sim■I�I BBLDING PERMIT APPLICATN <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 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 l(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2202 100th St SW PARCEL#: 00538200004300 <br /> offy Everett STATE WA zip 98204 <br /> SUITE/UNIT#: N/A FLOOR#:Ground ADDITIONAL LOCATION INFORMATION (if applicable):N/A <br /> TENANT/BUSINESS NAME(if non-residential):TO011eSs Plastic Solutions <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Paine Field 5 BLK Lot No.:43 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:100 Airport 100 LLC <br /> OWNER MAILING ADDRESS: STREET PO Box 1243 <br /> eny Edmonds STATE WA zjP 98020 <br /> OWNER PHONE:425-493-1223 OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:M R Racks LLC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):MRRACL924BN CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54079 <br /> CONTRACTOR ADDRESS: STREtT500 SW 16th St <br /> CITY Renton STATE WA zip 98057 <br /> CONTRACTOR PHONE:425-207-0058 CONTRACTOR EMAIL:matt@mrracks.com <br /> PRIMARY CONTACT: 0 OWNER 11 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-697_1241 <br /> Matt Prevost CONTACT EMAIL:matt@mrrackS.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$4,395.00 _ ASSOCIATED LAND USE PROJECT#(if applicable):N/A <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:Warehouse Floor Storage <br /> PROPOSED USE OF BUILDING:Warhouse Pallet Rack Storage <br /> HEAT SOURCE: ❑✓Gas ❑Electric Daher <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU DMulti-Family-#Units: i1Commercial DAccessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use <br /> ['Modular ❑Portable ❑Re-roof ['Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high lRackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:Supply seismic calculations and rack components to customer's exisitng pallet rack. <br /> Install per stamped seismic calculations, stamped floor plan and detail sheet. Special <br /> anchor is included. <br /> 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 <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.I am the owner,or l 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 /> ((kV\ tVA4A----- KlAtaedkrSaL9...-1 6-2022 PERMIT# <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br /> V2 <br />