3003 W CASINO RD BLDG 40-41 2025-07-31

■III HILDING PERMIT APPLICAT--1 CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink poly Please) PROJECT SITE INFORMATION e PROJECT SITE ADDRESS: STREET 3003 West Casino Rd PARCEL#: 28041000100200 CITY Everett STATE Wa ZIP 98204 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): Boeing LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Boeing Co OWNER MAILING ADDRESS: STREET 3003 West Casino Rd CITY Everett STATE Wa ZIP 98204 OWNER PHONE: 425-260-2668 OWNER EMAIL: todd.j.haberlack@boeing.com CONTRACTOR COMPANY NAME:TBD C�ejtur (?f11i.1 I h4 c H i CAP WA STATE CONTRACTOR LICENSE#(REQUIRED): LIEN E RCCI S.3d g CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1059 / CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: D OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-260-2668 Todd Haberlack CONTACT EMAIL:todd.j.haberlack@boeing.com BUILDING INFORMATION VALUATION OF WORK:$142,000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Manufacturing PROPOSED USE OF BUILDING:Manufacturing HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ©T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ETank(above ground) ❑Other: DESCRIPTION OF WORK: 40-41 bldg. To build/install a new Lab conference room approx. — 500 F pECE V NOV 16 2023 11:),) CITY OF EVERETT ACKNOWLEDGEMENT*I have reviewed this application and confirm the information contained herein is true and correct.Work done p rsuant to t is permit must comply with 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 Bu': •r 0,icial b-for: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, . , %�- .ntractors Law 18.27 RCW and 296.200A WAC. �j��lr fi t . City of Everett Official Use Only odd Haberlack, Digitally signed by Todd Haberlack, PERMIT# 48308 � 04 "'[f, C� 48308 Date:2023.11.13 08:25:38-08'00' r' ✓ _ Owner/Authorized Agent Signature Date (Revised 4/21/2022)