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E 112 BUILDING PERMIT APPLICATI•ON <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)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1111 80th Street SW PARCEL#: 01130400010000 <br /> CITY Everett STATE wa ZIP 98203 <br /> SUITE/UNIT#: 100 FLOOR#: main ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Jamco America <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:JAMCO AMERICA <br /> OWNER MAILING ADDRESS: STREET 1111 80th Street SW <br /> city Everett STATE WA zip 98203 <br /> OWNER PHONE:425-501-2373 OWNER EMAIL: warren_pike@jamco-america.com <br /> CONTRACTOR COMPANY NAME:select Contracting <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):SELECC*83501 CITY OF EVERETT BUSINESS LICENSE#(REQ IRED): <br /> CONTRACTOR ADDRESS: STREET PO BOX 1746 <br /> cn-y BOTHELL, STATE wa ZIP 9t3041-17 6 <br /> CONTRACTOR PHONE:206-419-8871 CONTRACTOR EMAIL:selectcontracting@gmail.com <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR n OTHER(Please Specify) architect <br /> CONTACT NAME: CONTACT PHONE:206-713-4076 <br /> keith smith CONTACT EMAIL:ksmith@smithco.org <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$150000 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:F, S, B <br /> PROPOSED USE OF BUILDING:F, S, B <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 /> THE WORK INCLUDES TENANT IMPROVEMENTS TO AN EXISTING <br /> WAREHOUSE, ADDING <br /> A NEW STAIR CONNECTION NEW NON-STRUCTURAL WALLS, LET, <br /> NEW PARTIAL Nth <br /> HT. WALLS, ADDING " <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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# _ O <br /> keith smith by keel <br /> Date 021po 011143s6tm'oo' 05/01/2021 bZ- to <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br /> /Z <br />