3700 FEDERAL AVE PORTABLE 5 JACKSON ELEMENTARY 2025-08-07

BUSING PERMIT APPLICATI EVERETT CITY OF EVERETT PERMIT SERVICES 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((E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 3700 Federal Ave PARCEL#: 00605000500000,29053000302600 CITY Everett STATE WA ZIP 98201 SUITE/UNIT#: P5 FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Everett School District No.2 LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Everett School District No.2 OWNER MAILING ADDRESS: STREET 3900 Broadway CITY Everett STATE WA ZIP 98201 OWNER PHONE:(425)385-4195 OWNER EMAIL: Jcollins@everettsd.org CONTRACTOR COMPANY NAME:Pacific Mobile Structures, Inc. Id. WA STATE CONTRACTOR LICENSE#(REQUIRED):PACIFMS033DC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 13806 45th AVE NE ciTy Marysville STATE WA ZIP 98271 CONTRACTOR PHONE:(360)345-1577 CONTRACTOR EMAIL:bobbie.leneker@pacificmobile.com PRIMARY CONTACT: ❑OWNER CI CONTRACTOR ❑✓ OTHER(Please Specify) Architect CONTACT NAME: Zach Ham CONTACT PHONE:(425)609-2315 CONTACT EMAIL:ZachH@dykeman.net BUILDING INFORMATION VALUATION OF WORK: $9,615.44 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:E-Educational PROPOSED USE OF BUILDING:E-Educational HEAT SOURCE: ❑Gas ✓❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: E JCommercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ENew Construction EAddition ❑Remodel ❑Repair ❑T.t. ❑Change of Use ❑Modular ❑✓Portable ❑Re-roof ❑Exterior Alteration ETank(above ground) ❑Accessary Structure ElFence over 7ft high ❑RackStorage EPool/Hot Tub ❑Tank(above ground) DOther: DESCRIPTION OF WORK: Existing P5 portable to be relocated within Jackson Eleme site with applicable site work including foundation pad, welcome ramp, and landin rite l D MCA FEB 11 2024 CITY OF EVERETT PCr rnit Services 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 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 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, and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Z--/1/ ,,� PERMIT# 5, P o� 0 ner/A ri Agent ignature ate (Revised 4/21/2022)