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E BIDING PERMIT APPLICATIR <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 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> 0260935 <br /> PROJECT SITE ADDRESS: STREET 4919 EVERGREEN WAY PARCEL#:( (-f 4Ai—!l .14-- <br /> clTv EVERETT STATE WA ZIP <br /> 98203 <br /> 0 <br /> !SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):QFC <br /> ILEGAL.DESCRIPTION for new construction Short Plat/subdivision Lot No.. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> UOViiNER NAME:Q F C#50852 <br /> rOWI1ER MAILING ADDRESS: STREET 1014 VINE ST <br /> CINCINNATI STATE OH ZIP 45202 <br /> clry ._r <br /> OWNER PHONE:(513) 762-4000 OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:Tundra Electric LLC Jv ,t� <br /> A.STATE CONTRACTOR LICENSE#(REQUIRED):TUNDREL789D5 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):CSL l -O y <br /> )C L.:l'TRACTOR ADDRESS: STREET 2311 N. 45th STREET <br /> Cory SEATTLE STATE WA ZIP 98103 <br /> liC3 a RACTOR PHONE:(206)670-3825 CONTRACTOR EMAIL: <br /> ,PlliIIARY CONTACT D OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Agent <br /> ri;:O N'"ACT NAME'. CONTACT PHONE:(909)455-2588 � <br /> Juan Al o n so CONTACT EMAIL:Johnny@verxile.com (/6f 01 Cpu', <br /> at..� BUILDING INFORMATION <br /> ,F*ION OF WORK:$6500 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> -iie rhaii Include the prevailing fair market value of all labor,materials.and equipment needed to complete the work,whether actually paid or not.) <br /> ISF; F BUILDING:M ._... <br /> :'-.D USE OF BUILDING: <br /> • -.,I;O RCE: ._IGas ❑ lectnc ❑Other. <br /> CMG TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> -r5 r'r PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑✓T.I. ❑Change of Use <br /> 2 ._.iPOrtable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> __o,ier 7ff high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: _ w <br /> - = F`ORI OF WORK: <br /> INSTALL WANZL CLASSIC SWING ACCESS SYSTEM AT ENTRANCE. SYSTEM <br /> DESIGNED TO OPEN WITH ONLY 5LBS OF PRESSURE IN CASE OF <br /> EMERGENCY. SYSTEM NOT TO ALTER EGREESS PATH OF TRAVEL. SYSTEM <br /> ELECTRICAL TO BE FROM NEAREST 20AMP CIRCUIT USING #12 VVIRING <br /> Et_,E,0,,,t.I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply v-L_. <br /> .::4';>: and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from;n, <br /> .;erort: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. I>_i <br /> ,fr:the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Cniy <br /> PERMIT <br /> 2-/ 2 to 3 D l - 006 <br /> ?# <br /> .ue Signature Date (Revised 4/21/2022) <br />