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BUILDING PERMIT APPLICATfON <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <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 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 1920 Merrill Creek Pkwy PARCEL#: 28040200401100 <br /> clr- Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):UMC, Inc. <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:BPP Pacific Industrial WA Reit Owner; LLC c/o LBA Realty <br /> OWNER MAILING ADDRESS: STREET 600 University Street, Suite 3025 <br /> cITY Seattle STATE WA ZIP 98101 <br /> OWNER PHONE:(206) 812-1000 OWNER EMAIL: leasingnotices@lbarealty.com <br /> CONTRACTOR COMPANY NAME:DACO Corporation <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):DACOC**012NC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET8825 S 184th St <br /> CITY Kent STATE WA ZIP 98031 <br /> CONTRACTOR PHONE:2535692219 CONTRACTOR EMAIL:davidh@appliednW.com <br /> PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:2525692219 <br /> David Hires CONTACT EMAIL:davidh@appliednw.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$212,067 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:Vacant <br /> PROPOSED USE OF BUILDING:Manufacturing <br /> HEAT SOURCE: ❑✓Gas ❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse Duplex EADU ❑Multi-Family-#Units: ✓❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check a/I 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 ERackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:Installation of racking and shelving <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 /> Buil i 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, <br /> and I co ply with the Stat Contractors haw 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Authorized Agent Sigtlatu Dat (Revised 2/8/2021) <br /> `I <br /> 6 <br />