3000 ROCKEFELLER AVE ADMIN BLDG WEST 2024-10-25

B!LDING PERMIT APPLICATt CITY OF EVERETT PERMIT SERVICES FAR 1 1 2023 ECEOVED EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal require and hi.lrrMer of copies requirecLfaf review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd F..r . Drop Box. CONTACT INFORMATION:(P)425-257-8810 (E)PermitServices@everettwa.goCin7yveftw c us? . (Blue or Black ink Only Please) PROJECT SITE INFORMATION Permit Services PROJECT SITE ADDRESS: STREET 3000 Rockefeller Ave. PARCEL#: ciTY Everett STATE WA ZIP 98201 SUITE/UNIT#: 3 West FLOOR#:3 ADDITIONAL LOCATION INFORMATION (if applicable):Admin.West Bdg. TENANT/BUSINESS NAME(if non-residential):SnOhOmish County Elections LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:SnohomiSh County OWNER MAILING ADDRESS: STREET 3000 Rockefeller Ave. - Facilies M/S 404 CITY Everett STATE WA ZIP 98201 OWNER PHONE:(425) 328-5510 OWNER EMAIL: Jeff.Hencz@Snoco.org CONTRACTOR COMPANY NAME:TBD 'Bolt ('Dushew/ban WA STATE CONTRACTOR LICENSE#(REQUIRED): B L6C_L8 3(0JT ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): �'I g 75 CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: D OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425\ 328-5510 Jeff H e n cz CONTACT EMAIL:Jeff.Hencz@Snoco.org BUILDING INFORMATION VALUATION OF WORK:$$6,022,000 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:Office PROPOSED USE OF BUILDING:Office/Ballot Tabulation 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 ERepair ❑✓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:Asbestosi abatement and TI demolition followed by constructidn of tenant improvements to accomodate the secure ballot tabulation process for elections while providing visibilty for public observation. 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.1 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 [f (IQ—LOA PERMIT# 6® cam— © 1 Owner/Aut rized Agent Signature to (Revised 4/21/2022)