7725 EVERGREEN WAY BIG BOX OUTLET STORES 2023-04-06

Ar a imis LI BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVE R E T T 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 17 2 ) ale V L.L) PARCEL#: cn' 4 STATE Li., 14 ZIP 9? 2. 7 Z— SUITE/UNIT#: f-- / FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): 6() go), 4,.( SA i-e-_ LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: /,I a1/4.COP ( Le e 4 /4/1-8-OWNER MAILING ADDRESS: STREET /^/,� /6 7 6( /4/1-8- c SE CITY • /kS I "t .)-- STATE ZIPQ� �2-7 L OWNER PHONE: 41Z C 31 v- 3 V S 7 OWNER EMAIL: 14'i.(�t¢,eI f•j p/"it 1p , (`01.4",_ CONTRACTOR COMPANY NAME: RO let 5-t3 4AS l5 h Sj, • �-L C.- WA nn STATE CONTRACTOR LICENSE#(REQUIRED): K� C isY ^ L-!S �2 }`^o Gp.1$t 6 CY,C,LI. Ro?JSoe c->��3 VERETT BUSINESS LICENSE#(RE I ED): CONTRACTOR ADDRESS: STREET /(jj 3 c ea.,i No L-..._ IA)a--y A CITY a 4 -L_- h u� / STATE (I � ZIP / r 2- 77 CONTRACTOR PHONE: 3 60 - 31,0 -O j 2.- I CONTRACTOR EMAIL: tro tA,Ul,.,L c_ @��,,�;(, ea....-i PRIMARY CONTACT: 'OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: 1114 t , ' .p,,,e CONTACT PHONE: VI s--_ 3 I c j_ 3Vs7 / h- CONTACT EMAIL: ,14(4)v8j o, 6 6 6,- ,,,,, B DING INFORMATION 5,W' i A c2.S2 -co w VALUATION OF WOR $ / 5-i 00 ,�- ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevail' ' market value of all labor,mated quipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: Kati,I PROPOSED USE OF BUILDING: HEAT SOURCE: rkt as ❑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 NIT.l. ❑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: feerk7:74/1 f Rae/6 j , 04-tz'-F 6.2e--4-( C-,0Jci/7) ttj o 4 Wcure-Laux2 Pk!(e.-4- r,,..Gt. 'I�/ 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 un.- any circumstance.l 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 : :27 RCW and 296.200A WAC. (--L L-11- 2-3 City of Everett Official Use Only a ,o Owner/Authorized Agent 1. •---- �__ Date (Revised 2/8/2021)