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IIR <br /> UILDING PERMIT APPLICPION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> 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 or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 3003 West Casino Rd PARCEL#: 28041000100200 <br /> c'Ty Everett STATE Wa zip 98204 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): Boeing <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing Co <br /> OWNER MAILING ADDRESS: STREET 3003 West Casino Rd <br /> cl,.r, Everett STATE Wa ZIP 98204 <br /> OWNER PHONE: 425260-2668 OWNER EMAIL: todd.j.haberlack@boeing.Com <br /> CONTRACTOR COMPANY NAME:Schuchart `GR G Iasi C— <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED). CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):/0499 <br /> CONTRACTOR ADDRESS: STREET 919' hick °2-- <br /> CITY _ STATE �/(� ZIP ge/6 <br /> CONTRACTOR PHONE:206-786-3573 CONTRACTOR EMAIL:Bill.foster@schuchart.com <br /> PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-260-2668 <br /> Todd Haberlack CONTACT EMAIL:todd.j.haberlack@boeing.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $150,000 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:Maufacturing <br /> PROPOSED USE OF BUILDING:Maufacturing <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 /> Unbolt and remove 10' sections of metal on the North, South and East sides of the <br /> Paint Booth to allow for air flow and better life/safety access. <br /> 0-€34k C 16( C; `�s3 o44 1 S t- E SkN e,S5-oF '14 <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this pdtmit m��pl-Witt <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 comp h the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> /�0/�2 PERMIT# � ^O Moog <br /> / I QJ� <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />