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i BIDING PERMIT APPLICATIJ <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETTSUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> wASIIIINSTQN then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425.257.88101(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 315 Shuksan Way PARCEL#: 28040100304300 <br /> CITY Everett STATE WA Z P 93203 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(If non-residential):Amazon <br />' LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:DPIF2 WA 7 Mountain View, LLC <br /> OWNER MAILING ADDRESS: STREET 5500 Equity Avenue <br /> CITY Reno STATE NV ZIP 89502 <br /> OWNER PHONE:775-858-8080 OWNER EMAIL: AmazonDWS4-MountainviewWA@dermody.com <br /> CONTRACTOR COMPANY NAME:Wize Solutions Inc <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):WIZESS1900M3 CITY OF EVERETT BUSINESS LICENS (REQUIR` E <br /> CONTRACTOR ADDRESS: STREET 2500 S Decker Lake Blvd#30 <br /> cIT.r West Valley STATE UT ZIP 84119 <br /> CONTRACTOR PHONE:801-966-0210 CONTRACTOR EMAIL:jtrayner@wizesolutions.com <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR I]OTHER(Please Specify) Manufacturer <br /> CONTACT NAME: CONTACT PHONE:610-810-8813 <br /> Stephanie Genescritti CONTACT EMAIL:sgenescritti@equipto.com <br /> BUILDING.INFORMATION <br /> VALUATION OF WORK:$24,416.00 ASSOCI°T 0 L ANDRU,ySE PR�.-R EC.T#(if applicable): `1 <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:Warehouse <br /> PROPOSED USE OF BUILDING:Warehouse <br /> HEAT SOURCE: ❑Gas ['Electric ElOther <br /> BUILDING TYPE: ❑SFR ❑Townhouse ['Duplex ❑ADU ['Mufti-Family-#Units: ['Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): [New Construction ❑Addition ['Remodel ['Repair ✓❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ['Exterior Alteration ['Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ['Tank(above ground) ['Other: <br /> DESCRIPTION OF WORK: <br /> Install and anchor additional maintenance access platforms to an existing conveyance <br /> system located within an existing warehouse. <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 /> PERM �� 3 D� <br /> DigiWNy xlgrbtl by Matkutibiml <br /> 6 - vl <br /> Mackenzie Trist ,D„,P::�Z.D7.,fl,,:,><:�-��y <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) 1 <br /> 4 <br />