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B•DING PERMIT APPLICATIN <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)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2810 Colby Ave. PARCEL#: 00439166802200 <br /> cm, Everett STATE WA zip 98201 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Steve Corotas <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: EVERETT PLAT OF BLK 668 D-00 Lot No.: 22 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Steve Corotas <br /> OWNER MAILING ADDRESS: STREET 2810 Colby Ave. <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE:425-210-3817 OWNER EMAIL: stevecorotas@comcast.net <br /> CONTRACTOR COMPANY NAME: f&'• (L.> �` f <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET Z L°\.vy1, i�'rl 4 L eDt <br /> CITY ye,e, J e H- STATE LZ.j/A ZIP q J Q,' <br /> CONTRACTOR PHONE: l I G- I 7 CONTRACTOR EMAIL: S T"� 1` Zt SC`' c-G-yV,C6.4.S' 0/ <br /> PRIMARY CONTACT: grOWNER ElCONTRACTOR ❑✓ OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:425 252 2153 <br /> Adam Clark CONTACT EMAIL:adam@2812architecture.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $25,000 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:Business <br /> PROPOSED USE OF BUILDING:Business <br /> HEAT SOURCE: ❑Gas ❑✓Electric ❑Other <br /> BUILDING TYPE: LISFR ❑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 /> Tenant Improvement of 1920 sf business. Removing floors finishes, a ceiling grid, <br /> non-bearing interior walls, a chimney and enlarging a restroom. <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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 17- PERMIT# dt '06( <br /> Owner/Authorize Agent Signature Date (Revised 2/8/2021)p� JZ <br />