4000 RAILWAY AVE FORMA CONSTRUCTION 2023-05-30

E BLO.DING PERMIT APPLICATION' EVERETT CITY OF EVERETT SERVICES SUBMITTAL INSTRUCTIONS:See applicable submittal checklistPERMIT 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) (f.mp PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4015 Railway Ave PARCEL#: 29052100300800 ciry Everett STATE WA LIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential):Forma Construction LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Forma Construction OWNER MAILING ADDRESS: STREET 4015 Railway Ave clTv Everett STATE WA ZIP 98201 OWNER PHONE:206.276.5818 OWNER EMAIL: CrosbyO@formacc.com CONTRACTOR COMPANY NAME:Spane Buildings WA STATE CONTRACTOR LICENSE#(REQUIRE ):SPANEBI141 JD ITY OF EVERETT BUSINESS LICENSE#(RE UIRED): ,0 CONTRACTOR ADDRESS: STREET 1611 B k Way CITY Mount Vernon STATE WA ZIP 98273 CONTRACTOR PHONE:(360) 708-5141 CONTRACTOR EMAIL:Jim@Spane.com PRIMARY CONTACT: 0 OWNER ✓❑CONTRACTOR —1 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(360) 941-8656 Jodi Boyden CONTACT EMAIL:Jodimboyden@gmail.com f BUILDING INFORMATION VALUATION OF WORK: 00 ( 6 I q i/ Q41- 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:n/a PROPOSED USE OF BUILDING:Commercial HEAT SOURCE: ❑Gas L]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 L_IModular ❑Portable LiRe-roof LlExterior Alteration ❑Tank(above ground) OAccessory Structure ❑Fence over 7ft high L]RackStorage LiPool/Hot Tub L.1Tank(above ground) ❑Other: DESCRIPTION OF WORK:Proposed 30' x 30' pole barn 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. City of Everett Official Use Only PE�8/22/2021 `)J0 Owner/Autho ze Agent ignature Date (Revised 2/8/2021)