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BUIL`NG PERMIT APPLICATI01" <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements i S"A#e-r w, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 320 ar Street 2nd Floor Intake lc X. <br /> CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gov )everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 5131 Colby Ave PARCEL#: 29053(1T <br /> cay Everett STATE WA Permitt,$2otces <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):PACIFIC COAST SURVEYS <br /> LEGAL DESCRIPTION for new construction: Short Plattsubdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:RIDDLE DARREN/HEIDI <br /> OWNER MAILING ADDRESS: STREET 11425 53RD AVE SE <br /> cnY EVERETT STATE WA zip 98208-9228 <br /> OWNER PHONE:425.512.7099 x. 2112 1OWNER EMAIL: Darren@pcsurveys.net <br /> CONTRACTOR COMPANY NAME:TBD 13uI L&c-t"S J o) MV2wt.A , LL L <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):5U g8-1 t3r ICITYOFEVERETT BUSINESS LICENSE#(REQUIRED): 6/ (Q(0 2- <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) REPRESENTATIVE <br /> CONTACT NAME: CONTACT PHONE:(425) 252 2153 <br /> Paul Douglas (2812 Architecture) CONTACT EMAIL:paul@2812architecture.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $290,000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevaifng fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:Business <br /> PROPOSED USE OF BUILDING:Business <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 ❑✓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) ❑Other: <br /> DESCRIPTION OF WORK:A tenant improvement of an existing business building to be modernized for a survey <br /> company. <br /> Some partial demolition with new wall construction on the interior. Two new toilets will <br /> be added to the upper floor and the exterior stairs from the upper floor to the lower <br /> floor will be removed. A new stair on the interior will be added to link the upper and <br /> lower floors combining the two floors into one office space. <br /> ACKNOWLEDGEMENT:1 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 1 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 WAG. <br /> City of Everett Official Use Only <br /> Ak3t�(4 <br /> Owner/Authorized Agaa ignature Date (Revised 412112022) <br />