Laserfiche WebLink
E <br /> •LDING PERMIT APPLICAltN <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETTSUBMITTAL 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)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET Seaway West Bld B PARCEL#: 28040300400300 <br /> clrr Everett STATE WA zip 98203 <br /> SUITE/UNIT#: 3301 FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):TerraPOWer <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: n/a Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:SEAWAY WEST LLC <br /> OWNER MAILING ADDRESS: STREET 8201 164TH AVE NE STE 200 <br /> clty REDMOND STATE WA ZIP 98052 <br /> OWNER PHONE:425.457.7456 OWNER EMAIL: kevink@jshproperties.com <br /> CONTRACTOR COMPANY NAME TB V Co, `7e-VA. 6 ,� <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):Q Pc tF s-G CJ 17-C7CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): L100 6 0 <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: 0 OWNER LI CONTRACTOR ❑✓ OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:206-228-8000 <br /> Randy Brown CONTACT EMAIL: Randy.Brown@synthesispllc.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$400K 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: Warehosue/Office <br /> PROPOSED USE OF BUILDING:WarehoUSe/Office <br /> HEAT SOURCE: ❑✓Gas ❑E€ectric ❑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 DT.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:Tenant Improvement - Office space in a existing Industrial Shell <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 focal 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 9fficial before being authorized under any circumstance.I am the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 ROW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> vAA,04 t.. <br /> �i �- �� PERMIT- ^f 20�� Dr <br /> Ow rlAuthorizd Agent Signature Date (Revised 2/8/2021) <br />