Laserfiche WebLink
BISDING PERMIT APPLICAT41N <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETT 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 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits <br />or Btack /nk'Orrly P/.ease) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: STREET 2828 Colby Street, Suite 200 & 300 PARCEL #: 35040500040006 <br />CITY Everett, WA 98201 STATE ZIP <br />SUITE/UNIT #: 200 & 300 FLOOR #: 2 & 3 ADDITIONAL LOCATION INFORMATION (if applicable): <br />TENANT/BUSINESS NAME (if non-residential): Kimley-Horn <br />LEGAL DESCRIPTION for new construction: Short Plat/subdivision: n/a Lot No.: n/a (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: �, I't1 S $ �(* `L c <br />AA <br />OWNER MAILING ADDRESS: STREET �jG ew l Atle S t4 ia2 �U <br />CITY �'VC✓�i� STATE tl% ✓4 ZIP 8 feC' <br />OWNER PHONE: 6 goo <br />OWNER EMAIL: L� ✓�`/ . pot -A � 5 v�c�ct/t <br />CONTRACTOR COMPANY NAME: P T <br />WA STATE CONTRACTOR LICENSE #(REQUIRED): }A f q 6( f� <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): � & 6 9-4t/5' <br />CONTRACTOR ADDRESS: STREET 2-0 / 4 re k r 2 2 <br />CITY �1 e STATE tV4 ZIP 1 2 <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />PRIMARY CONTACT: ❑ OWNER J] CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: UGti/"� S <br />CONTACT PHONE: <br />CONTACT EMAIL: �� 5 c, uI-�� GL, ( c, �,•� <br />BUILDING INFORMATION <br />VALUATION OF WORK: $ G <br />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: Business <br />PROPOSED USE OF BUILDING: Business <br />HEAT SOURCE: ❑Gas ❑✓ Electric ❑Other <br />BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑✓ Commercial ❑Accessory Structure <br />TYPE OF PROJECT (check all that apply) : El New Construction ❑Addition R]Remodel ❑Repair ❑✓ T.I. ❑Change of Use <br />❑Modular ❑Portable ❑Re -roof El Exterior Alteration ❑Tank (above ground) ❑Accessory Structure <br />❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank (above ground) ❑Other: <br />DESCRIPTION OF WORK: -tenant finis 1 out Of Second generation Space <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. 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 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PERMIT # 3 0, `7- N( ^ <br />(Revised 412112022) / <br />