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Elm <br /> ra BIDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � <br /> EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements in m ,�',-Or`N in r iew, <br /> WASHI NGTON then drop off completed application plus all required submittal documents to 320) dar Street 2nd Floor Intake Drop ox. <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov1*)eveCettµ�(a.gok/perOmits J <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION )( L. Id L LJ <br /> PROJECT SITE ADDRESS: STREET 3301 SEAWAY BLD B PARCEL#: 280403(G}FbbY OF EVERETT <br /> CITY EVERETT STATE WA Perms}ziPaNiC@S <br /> SUITE/UNIT#: FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): TERRA POWER <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: JSH Properties(Property Manager) <br /> OWNER MAILING ADDRESS: STREET 14900 INTERURBAN AVE SO, SUITE 130 <br /> CITY SEATTLE STATE WA ZIP 98168 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:PATTISON GENERAL CONTRACTOR <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):PATTIGC917C7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 040060 <br /> CONTRACTOR ADDRESS: STREET 15223 NE 90TH ST,SUITE 140 <br /> clTY REDMOND STATE WA ZIP 98052 <br /> CONTRACTOR PHONE:425-497-8222 CONTRACTOR EMAIL:andyf@pattisongc.com <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425 985 0581 <br /> A M Y N I C H O LS CONTACT EMAIL:amyn@jpcarchitects.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $12,000 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:B&S-1 <br /> PROPOSED USE OF BUILDING:B,Si- & F-1 <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 C✓IT.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: PROPOSED CHANGE OF OCCUPANCY FROM B/S-1 TO B/F-1 . CONSTRUCTION <br /> OF NEW INTERIOR CHAIN LINK FENCING. <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 Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Digitally signed by Amy Nichols PERMIT# <br /> y DM CN-Amy Nichols,OU=Principal,OU=JPC 04/11/23 �_27 �o �� <br /> Amy Nichols Date52023 04c 10 117e35 20 07 GOm <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />