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am <br /> az BU•ING PERMIT APPLICATIO. <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)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 747 75th Ave SE PARCEL#: 0108100410400 <br /> crry Everett StAir WA zip 98203 <br /> SUITE/UNIT#: building C FLOOR#:three ADDITIONAL LOCATION INFORMATION Of applicable): <br /> TENANT/BUSINESS NAME(if non-residential): Lakeside Apartments <br /> LEGAL DESCRIPTION for new construction: Short Platisubdivision. Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: WESTLAND INVESTORS <br /> OWNER MAILING ADDRESS: STREET 915 BROADWAY ST SUITE 100 <br /> cin, VANCOUVER STATE WA zIP 98660 <br /> OWNER PHONE: 206-434-1100 OWNER EMAIL: HCFRITZEMEIER_1@Q.COM <br /> CONTRACTOR COMPANY NAME: '?( C.- 051� S/CS 1�1. �� <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED (+/�� , ` T�F EVERETT BUSINESS LICENSE#(REQUIRED): 6539 L <br /> CONTRACTOR ADDRESS: STREFT 1 <br /> ;I TY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: 0 OWNER _._',CONTRACTOR [✓OTHER(Please Specify) ARCHITECT OF RECORD <br /> CONTACT NAME: CONTACT PHONE:206.434.1 1 00 <br /> CHARLES FRITZEMEIER CONTACT EMAIL:HCFRITZEMEIER_1@Q.COM <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: s $50,000 ASSOCIATED LAND USE PROJECT#(if applicable): NONE <br /> (Valuation shall include the prevailing fait nldrket value of all labor,materials,and equipment needed to complete the work_whether actually paid or not) <br /> EXISTING USE OF BUILDING: APARTMENTS <br /> PROPOSED USE OF BUILDING: SAME - APARTMENTS <br /> HEAT SOURCE: [Gas i]Electric LiOther <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU Multi-Family-#Units:33 Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): -7New Construction ❑Addition 'Remodel L'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) _JOther: <br /> DESCRIPTION OF WORK:PROJECT INVOLVES REPLACEMENT OF UPPER LEVEL WALKWAYS, REMOVE <br /> EXISTING AND REPLACE WITH SIMILAR, MAKE REPAIRS AS NECESSARY IN <br /> AREA LIMITED TO THE THIRD LEVEL OF BUILDING 'C' WALKWAY. <br /> ACKNOWLEDGEMENT.I have reviewed this applic'J��.' •id confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> � <br /> current federal,state,and local law The granting of/ only authorizes approved work and no deviations therefrom.Deviations must first be authonzed in writing from the <br /> Building Official before being authorized uno- ;wll.11..;.l�tg,ram• , . •owner,or I am authorized by the owner of this property to perform the work for winch application is made. <br /> and I comply with the State Contractors Law 18.' •e /Fj.t ir I i 1'.C. <br /> /II l i City of Everett Official Use Only <br /> • <br /> ii..�`, ' 09.24.2023 ! 2? \D- v , <br /> Owner/AuthorizedAgentSi natur' Date (Revised 4/21/2022) <br /> g <br />