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MIN <br /> �ILDING PERMIT APPLICATI* <br /> CITY OF EVERETT PERMIT SERVICES APR 2 8 2023 EcENE1 <br /> EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements d umber of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cerha ad f�"Box. <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov I(Vlf)€ r tt v P�s <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION Clint cry ceE <br /> PROJECT SITE ADDRESS: STREET 6307 36th Ave W, Bldg C PARCEL#: 28040300401200 <br /> clay Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: 1 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Deluxe Corp <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: 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, Suite 350 <br /> CITY Seattle STATE WA ZIP 98188 <br /> OWNER PHONE:425-974-4015 OWNER EMAIL: brent.jackson@am.jll.com <br /> CONTRACTOR COMPANY NAME:Northwest Handling Systems <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):CC NORTHWH275JF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 011598 <br /> CONTRACTOR ADDRESS: STREET 1 100 SW 7th St <br /> CITY Renton STATE WA ZIP 98057 <br /> CONTRACTOR PHONE:425-919-3597 CONTRACTOR EMAIL:neilm@nwhs.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-919-3597 <br /> Neil Montague CONTACT EMAIL:neilm@nwhs.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$364,846.00 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 <br /> HEAT SOURCE: ✓❑Gas ❑Electric Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: LlCommercial ❑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 (320) bays of selective pallet racking <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 bei 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 St e Contractors Law 18.27 RCW and 296,200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 3;.1 �o tf © 17 <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />