2729 COLBY AVE H & R BLOCK 2024-10-24

U lSl�LgLI V' lj sum BRING PERMIT APPLICATIO1 JUN 0 9 2023 CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements((� F-of i • for review, WASHINGTON then drop off completed application plus all required submittal documents to 320Q�e t o Drop Box. CONTACT INFORMATION: (P)425-257-8810 I (E)PermitServices@everettwa.gov I (VD)F'e+ri E roir (Blue or Black Ink Only Please) PROJECT SITE INFORMATION /' PROJECT SITE ADDRESS: STREET 2729�olby Ave PARCEL#: r 288G0790386499 COL/3 16 /3vo CITY Everett STATE WA ZIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): HR Block# 63735 LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:COLUMBIA CASCADE PLAZA LLC OWNER MAILING ADDRESS: STREET PO BOX 790830, SAN ANTONIO, TX 78279-0830 CITY STATE ZIP OWNER PHONE:425-422-4699 OWNER EMAIL: CONTRACTOR COMPANY NAME:TBD lam'I SO r Co VY)tYIXA—dt aS Co nS trvt,CI\C)Y) /_ ?q WA STATE CONTRACTOR LICENSE#(REQUIRED):C&NSOULg35I.-W CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): l(l&3 6 69 CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Agent/Applicant CONTACT NAME: CONTACT PHONE:608-844-7303 Paul Landa CONTACT EMAIL:pawl@permit.corn BUILDING INFORMATION VALUATION OF WORK: $50000.00 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials.and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Business/Retail PROPOSED USE OF BUILDING:Retail HEAT SOURCE: ❑✓Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair I]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: Minor interior architectural finish work. Minor electrical upgrades in existing panel 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 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 I 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? /aal./-1 rj�{a te 6/5/23 PERMIT# 06 Owner/Authorized Agent Signature Date (Revised 4/21/2022)