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BUILDING PERMIT APPLICATION <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 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1701 121ststreel SE PARCEL#: 28053000100900 <br /> CITY Everett STATE WA ZIP 98208 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable):Amenity Building <br /> TENANT/BUSINESS NAME(if non-residential):Charter Club Apartments <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Cody Jones,C/O Security Properties <br /> OWNER MAILING ADDRESS: STREET 701 5th Avenue,Suite 5700 <br /> CITY Seattle STATE WA ZIP 98104 <br /> OWNER PHONE:206-628-8007 OWNER EMAIL: oodyj@secprop.com <br /> CONTRACTOR C PANY NAME: <br /> A STATE CONTRACTOR QUIRED)ki_ j OF EVERETT BUSINESS LICENSE#(REQUIF EON <br /> OVE <br /> CONTRACTOR ADDRESS: STREET UG <br /> CITY STATE <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: APR O 1 2024 <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:206-782-8208 EVERETT <br /> Ben Thornton CONTACT EMAIL:bthornton@clarkbames.com Pei m r ices <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$411,000 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:leasing offices,amenity and fitness center <br /> PROPOSED USE OF BUILDING:leasing offices,amenity and fitness center(no change of use) <br /> HEAT SOURCE: ❑Gas DElectric ❑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:REMODEL OF THE EXISTING 4,510 GROSS SF,TWO-STORY,TYPE V-A <br /> CONSTRUCTION, LEASING/AMENITY BUILDING WITHIN THE CHARTER CLUB <br /> APARTMENT COMPLEX. SCOPE INCLUDES STRUCTURAL AND NON-STRUCTURAL <br /> INTERIOR WORK, DEMOLITION OF EXISTING FLAT ROOF ENTRY CANOPY AND <br /> EXTENSION OF EXISTING ROOF GABLE, NEW AND REVISED EXTERIOR WINDOWS <br /> AND DOORS,AND REVISED EXTERIOR DECKING <br /> ACKNOWLEDGEMENT:f 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.f am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and f comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 11/7/23 PERMIT# <br /> L61A <br /> Owner/Autho zed gent Signature Date (Revised 4/21/2022) <br />