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BIDING PERMIT APPLICATI1 <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 2812 Rucker Ave PARCEL#: 00439167002400 <br /> cnTy Everett STATE WA ZIP 98206 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Fastsigns <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Goldfinch Brothers Inc <br /> OWNER MAILING ADDRESS: STREET 11300 Beverly Park Rd <br /> CITY Everett STATE WA ZIP 98204 <br /> OWNER PHONE:(425)258-4662 OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:Oceanview Construction <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): G Lt I�` g CONK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6 (loll- <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE:(360)317-8125 CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:(360)540-8223 <br /> Al I r CONTACT EMAIL:taylordesignarch@yahoo.com <br /> BUILDING INFORMATION -- - <br /> I <br /> VALUATION OF WOR :$2,500 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the pre fling fair mark..value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILD •w- ehouse <br /> PROPOSED USE OF BUILDING:warehouse <br /> HEAT SOURCE: EGas ❑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 LIRe-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 /> Remove (2) doors and replace <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.1 am the owner,or lam 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 /> PERMIT# O D <br /> Al Taylor °at':'" 'N °"°"°` ©J _ 9 <br /> Y oms.2et,.m oa,z:u:zs-orroo• IJ 2 <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) • <br />