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Imo <br /> BUILDING PERM <br /> IT APPLICAT <br /> IRN <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 /> WA$HINGTON 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.govipermits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 6500 Merrill Creek Parkway PARCEL#: 28040200301300 <br /> cny Everett STATE WA zip 98203 <br /> SUITE/UNIT#: FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME (if non-residential):AvtechTyee <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: See attached Lot No.: (attach copy of long legal description <br /> CONTACT INFORMATION <br /> OWNER NAME:NWB Merrill Creek LLC <br /> OWNER MAILING ADDRESS: STREET 801 2nd Ave., Suite 1300 <br /> c3 v Seattle STATE WA z,r. 98104 <br /> OWNER PHONE:206-652-8752 OWNER EMAIL: samson.b@nwbld.com <br /> CONTRACTOR COMPANY NAME:TCL Partners <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):TCLPAPC919QD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 049073 <br /> CONTRACTOR ADDRESS: STREET 16000 Mill Creek Blvd#103 <br /> CITY Mill Creek STATE WA _,F 98012 <br /> CONTRACTOR PHONE:425-316-3500 CONTRACTOR EMAIL:bmerisko@tclpartners.com <br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR )J OTHER(Please Specify) Harold Christensen of Lance Mueller Architects <br /> CONTACT NAME: CONTACT PHONE:206-325-2553 <br /> Harold C rh i ste n se n CONTACT EMAIL:haroldc@Imueller.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$75,000 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:Office,manufacturing, storage warehouse. <br /> PROPOSED USE OF BUILDING:Same <br /> HEAT SOURCE: ❑✓Gas _Electric L iOther <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑,Duplex ❑ADU ❑Multi-Family-#Units: EfiCommercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction [-Addition ERemodel LiRepair HChange of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) Li Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub 17Tank(above ground) DOther: <br /> DESCRIPTION OF WORK: <br /> Add new wall and door at lobby to create secure vestibule. Add door from vestibule to <br /> existing conference room. Add new wall and door at mezzanine alcove to create small <br /> office. <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.1 am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 295.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 1-24-2022 13 7, " MOO <br /> wner/Authorized Agent Sign re Date (Revised 218/2021) <br /> hi <br />