1313 75TH ST SW 2023-12-11 - Laserfiche WebLink

i BUILDING PERMIT APPLICATISt1 CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINOTON 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1313 75th St SW PARCEL#: 28041100100100 clry Everett STATE WA ZIP 98203 SUITE/UNIT#: N/A FLOOR#:N/A ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Middle Earth Holdings, LLC LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Middle Earth Holdings, LLC OWNER MAILING ADDRESS: STREET 8210 154th Ave NE 100 CITY Redmond STATE WA ZIP 98052 OWNER PHONE:425-495-4215 OWNER EMAIL: paul@helionenergy.com CONTRACTOR COMPANY NAME:Andersen Construction WA STATE CONTRACTOR LICENSE#(REQUIRED):ANDERCC822BW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6041696740010001 CONTRACTOR ADDRESS: STREET5601 6th Ave S, Ste 550 CITY Seattle STATE WA ZIP 98108 CONTRACTOR PHONE:iburkett@andersen-const.com CONTRACTOR EMAIL:iburkett@andersen-Const.com PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-495-4215 Paul Gents h CONTACT EMAIL:paul@helionenergy.com BUILDING INFORMATION VALUATION OF WORK:$50 , 00 t C` $io ASSOCIATED LAND USE PROJECT#(if applicable):Pre-app 2007 (Valuation shall include the prevail' fair market value of all.)abor, aterials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF B LDING:light industrial PROPOSED USE OF BUILDING:light industrial HEAT SOURCE: ❑✓Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU DMulti-Family-#Units: ❑✓Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ✓❑T.I. ❑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:Foundation demolition, excavation, and replacement of 94' x 54' x 36" deep area inside the existing building, replacing the entire volume with a new, heavier reinforced foundation. ACKNOWLEDGEMENT.1 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 1 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 j 8/23/2022 � v22eg Owner/ thorized Agent Signature Date (Revised 4/21/2022) yl