Laserfiche WebLink
LT.T BDING PERMIT AF'PLICATON <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,cir BlackffikOnly Please PROJECTSITE-INFORMATION <br /> PROJECT SITE ADDRESS: STREEE36th Ave W,)dd‹ PARCEL#: 28040300401200 <br /> crn. EVERETT STATE WA zip 98203 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):TBD <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Sedfon3Tovmehip28Renge4OuerterSELOT2.BCOEI Lot No.: (attach copy of long legal description) <br /> . ... CONTACT INFORMATION` <br /> OWNER NAME:POWDERMILL PHASE 1 LLC <br /> OWNER MAILING ADDRESS: STREET 6840 FORT DENT WAY SUITE350 <br /> CITY SEATTLE STATE WA ZIP 98188 <br /> OWNER PHONE:425.283.5478 OWNER EMAIL:�� krissyl@jshproperties.com <br /> CONTRACTOR COMPANY NAME:TBD N O i V6 ct. CMS 1 f tc C� <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): �O�T C j.%5 C6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54-I 9(p <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:425 646 1818 (spa zZ e- g CG^v <br /> Randy Brown CONTACT EMAIL:randy.brown@synthesispllc.com <br /> =BUILDING:INFORMATION <br /> VALUATION OF WORK:$301,536 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:warehouse <br /> PROPOSED USE OF BUILDING:warehouse/distribution <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): ❑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 /> Speculative Office Tenant Improvement in an existing tilt up concrete shell. Consists of <br /> office spaces, break, toilets & warehouse demising wall. <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# <br /> t�/c 3r�r 2/10/2023 151.2 0 2 - ®g6 <br /> Owner/Aut ized Agent Signature Date (Revised 4/21/2022) <br />