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6JILDING PERMIT APPLICA1 ION <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 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> /PROJECT SITE ADDRESS: STREET 8407 Broadway PARCEL#: <br /> CITY Everett STATE WA ZIP 98208 <br /> SUITE/UNIT#: FLOOR#: 5 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Secure Space <br /> LEGAL DESCRIPTION for new construction' Short Plat/subdivision. self Storage Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Insite Property Group <br /> OWNER MAILING ADDRESS: STREET 19191 South Vermont Avenue STE 680 <br /> CITY Torrance STATE CA ZIP 90502 <br /> OWNER PHONE: 575-936-0877 /a OWNER <br /> ,EMAIL: <br /> , bsorensen@insitepg.com <br /> CONTRACTOR COMPANY NAME: e c c J OS colAs �v v��,vP� <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED3ZUJOCA 3 2e, TY OF EVERETT BUSINESS LICENSE#(REQUIRED):(a t(Q [ <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architectural Protect Manager <br /> CONTACT NAME: Casey Kispert CONTACT PHONE:2063244800 <br /> CONTACT EMAIL:casey.kispert@jacksonmain.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $10,472,536.00 t I('(\ ASSOCIATED LAND USE PROJECT#(if applicable): $10, .00 <br /> (Valuation shall include the prevai ng fair market value of all labor materials,and equipment needed to complete the work,whether actually paid or not) <br /> EXISTING USE OF BUILD! v — iO - 3 <br /> PROPOSED USE OF BUILDING: <br /> HEAT SOURCE: ❑✓Gas ❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse EDuplex ❑ADU ❑Multi-Family-#Units' ❑✓Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑✓New Construction ❑Addition ❑Remodel ❑Repair ❑T.I ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ETank(above ground) ElAccessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:FIVE STORY SELF STORAGE FACILITY ON PREVIOUSLY <br /> DEVELOPED SITE. PROPOSED BUILDING WILL BE 4 STORIES TYPE II-B <br /> CONSTRUCTON OVER 1 STORY TYPE I-A. <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 authonzed in writing from the <br /> Building Official before being authorized under any circumstance I am the owner,or I am authonzed 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 /> Date'2022 08.26 09 02 50-07'00'Casey Kispert C o <br /> casey.kispert@jacksonmain.com PErU #Z�g <br /> Owner/Authorized Agent Signature Date ( evised 4/21/2022) <br /> �—? 2 —D - <br />