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Be..,DING PERMIT APPLICATON <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 6300 Merrill Creek Parkway PARCEL#: 28040200301500 <br /> CITY Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: A-300 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): NA <br /> TENANT/BUSINESS NAME (if non-residential):PH Sciences <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: NA Lot No.: NA (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Steve Loyd <br /> OWNER MAILING ADDRESS: STREET 15022 35th Avenue West, Suite F <br /> CITY Lynwood STATE WA ZIP 98087 <br /> OWNER PHONE:206--683-5080 OWNER EMAIL: sloyd@phsciences.com <br /> CONTRACTOR COMPANY NAME:TCL Partners <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):TCLPAPC919QD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 049073 <br /> CONTRACTOR ADDRESS: STREET 16000 Mill Creek Blvd, Suite 103 <br /> CITY Mill Creek STATE WA ZIP 98012 <br /> CONTRACTOR PHONE:425-330-3107 CONTRACTOR EMAIL:bmerisko@tclpartners.com <br /> PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Twist Design,Inc. <br /> CONTACT NAME: CONTACT PHONE:206.402.4484 <br /> Olivia Nisbet CONTACT EMAIL:olivian@twist-design.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $75,000.00 ASSOCIATED LAND USE PROJECT#(if applicable):NA <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/Warehouse <br /> PROPOSED USE OF BUILDING:Office/Warehouse <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 i]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 /> Small TI in existing office space, add 3 new offices and lab space. Lab space will have <br /> a hood that will vent through the roof. Miscellaneous electrical, plumbing and <br /> mechanical will required to support new spaces, under separate permit by others. <br /> NOTE: THE TENANT IS IN COMPLIANCE WITH IBC SECTION 307.7, PER TABLES <br /> 307.1(1) AND (2). <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 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 /> PERMIT# �I D�- <br /> Q Z9 <br /> Olivia Nisbet Dale 0809 4l5703.01 lJ <br /> Dale.2021 oe.os is sr.w-oroo' <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br /> Z <br />