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INN <br /> LI BUILDING PERMIT APPLICATION <br /> 1 E V E R E T T CITY OF EVERETT PERMIT SERVICES <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 906 SE EVERETT MALL WAY PARCEL#: 28051800308500 <br /> CITY EVERETT STATE WA zip 98208-2814 <br /> SUITE/UNIT#: #300 FLOOR#: 3rd ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Consumer Direct <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:C,DLLIER61NTERNATIONAL <br /> OWNER MAILING ADDRESS: STREET 601 UNION STREET, SUITE 5300 <br /> CITY Seattle STATE WA ZIP 98101 <br /> OWNER PHONE:206-223-1262 OWNER EMAIL: vanessa.magnuson@colliers.com <br /> CONTRACTOR COMPANY NAME: 404-L e_ TLkx-v }ew yi <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): ?ej O �EVERETT BUSINESS LICENSE#(REQUIRED): C..f D <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) WARE MALCOMB(ARCHITECTS) <br /> CONTACT NAME: CONTACT PHONE:Cindy:425-582-5503/Amanda:425-582-5513 <br /> Cindy Kang Amanda SI(IUZBCeIC CONTACT EMAIL:ckang@waremalcomb.com/askluzacek@waremalcomb.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $350,000 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:OFFICE/B <br /> PROPOSED USE OF BUILDING:OFFICE/B <br /> HEAT SOURCE: ❑Gas ❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: 9Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair 0T.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 SCOPE OF THIS PROJECT INCLUDES A 3RD FLOOR TENANT <br /> IMPROVEMENT OF AN EXISTING OFFICE SPACE FOR USE OF THE SAME. <br /> DEMOLITION INCLUDES: WALLS, DOORS, CEILING, LIGHTING, AND FINISHES. <br /> CONSTRUCTION INCLUDES NEW WALLS, DOORS, CEILING, LIGHTING, <br /> FINISHES, NEW DEMISING WALLS. EXISTING RESTROOMS TO REMAIN. <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 18.2 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> . ,) PERMIT 13Z2 oil . 4IC <br /> e o e _ Ze............_ 03.25.2022 <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br /> 1�z <br />