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Emi <br /> BODING PERMIT APPLICAT•N <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 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 3003 West Casino Rd 6!Art 44J -31 PARCEL#: 28041000100200 <br /> c'TY Everett JJ 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 /> cm( Everett STATE Wa ZIP 98204 <br /> OWNER PHONE: 425-260-2668 OWNER EMAIL: todd.j.haberlaCk@boeing.Com <br /> CONTRACTOR COMPANY NAME:TBD u J(�, 13Ct{Y tA (i lO r,�yic 1% L_L Ci <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):TBDW 514L (DLQC1r CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):�3�' O� <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: oso1 j G*- La)- of,con <br /> PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-260-2668 <br /> Todd H a be rl ack CONTACT EMAIL:todd.j.haberlack@boeing.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $600,000 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:Manufacturing <br /> PROPOSED USE OF BUILDING:Manufacturing <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 /> DEMOLITION, FOUNDATION CONSTRUCTION, ELECTRICAL AND MECHANICAL WORK <br /> TO SUPPORT THE RELOCATION OF 40-05 PRIT/PRAT 1 TO WITHIN THE NW 40-31 <br /> BUILDING, <br /> INCLUDING REMOVAL OF AN EXISTING WALL. NO OTHER CHANGES TO BUILDING(S). <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 Co tractors Law 18.27 RCW and 296.200A WAC <br /> / City of Everett Official Use Only <br /> C/ �� Z 3 PERMIT# 2305... <br /> 305� o ✓� <br /> Owne horized Agent Signature ate (Revised 4/21/2022) <br />