2000 TOWER ST PILCHUCK HALL 2023-04-03

BUILDING PERMIT APPLICATION 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) PermitServices@everettwa.gov i (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2000 Tower Street PARCEL #: 29051700200100 clTY Everett STATE WA zIP 98201 SUITE/UNIT M Pilchuck Building FLOOR #: 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential): Everett Community College LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Erica Dias, Facilities Director OWNER MAILING ADDRESS: STREET 2000 Tower Street CITY Everett STATE WA ZIP 98201 OWNER PHONE:425.388.9516 1OWNER EMAIL: edlaSC@everettcc.edU CONTRACTOR COMPANY NAME:TBD WA STATE CONTRACTOR LICENSE #(REQUIRED): CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑✓ OTHER (Please Specify) Architect (owner's agent) CONTACT NAME: Jerry Osborn CONTACT PHONE:206.920.6348 CONTACT EMAIL:josborn@oaips.com BUILDING INFORMATION VALUATION OF WORK: $ 10,000 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: Storage PROPOSED USE OF BUILDING: Storage 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: Installation Of new 12-foot high Storage racks 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. Owf ;(Authori*d Agent Signature City of Everett Official Use Only PERMIT # (Revised 412112022)