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BIDING PERMIT APPLICATION RVEsC CITY OF EVERETT PERMIT SERVICESQEVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requiremenumber of copies required f view, <br /> WASHINGTONthen drop off completed application plus all required submittal documents to 3a���''t F.. ntake Box. <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.g eYe�ttwW.gbv/,t •its <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION CITY OF,FVERETT <br /> PROJECT SITE ADDRESS: STREET 1520 80th St SW PARCEL#: Permit Services <br /> CITY Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: Building B FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Helion Energy <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Helion Energy <br /> OWNER MAILING ADDRESS: STREET 1415 75th St SW <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE: `C( "- OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:Helion Energy <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET 141 5 75th St SW <br /> CITY Everett STATE WA ZIP 98203 <br /> CONTRACTOR PHONE:425-332-7463 CONTRACTOR EMAIL:helion@helionenergy.com <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑✓ OTI -R(Please Specify) Applicant <br /> CONTACT NAME: COI \CT PHONE:936-776-1541 <br /> Tyler Landry CON1. ;T EMAIL:ty1731@helionenergy.com <br /> BUILDING INFORMATION <br /> VALUATION OF W K: $1000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the evailing fair mark value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING: <br /> PROPOSED USE OF BUILDING: <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 El 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: Designating (2) outdoor control areas for storage of compressed gases. Storage in <br /> each area is not to exceed the MAQ in each area. <br /> ove,A. sehm, _ Nic-, __O-if\A-1,Z. ;)( •-kie-0----- <br /> "?i 1)'lv. As CO' ' c-r' - — AJQ (i2,661— ,h)- v-4- <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 C actors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> \// -- <br /> 08/29/2023 PERMIT# '7 "--) S v <br /> Owner/Authoriz Agent Sig a Date (Revised 4/21/2022) <br />