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BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 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)everetteps@everettwa.gov I (W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2600 Federal Ave PARCEL <br /> clTy Everett STATE WA zIP 98201 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Port Of Everett <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Port Of Everett <br /> OWNER MAILING ADDRESS: STREET 1205 Craftsman Way <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE:425-259-6001 1OWNER EMAIL: steveh@portofeverett.Com <br /> CONTRACTOR COMPANY NAME:Strlder Construction <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):strldCC1 21 oz CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 61790 <br /> CONTRACTOR ADDRESS: STREET4721 Northwest Dr <br /> CITY Bellingham STATE WA ZIP 98226 <br /> CONTRACTOR PHONE:360-380-1234 1CONTRACTOR EMAIL:Info@strlderconstructlon.Com <br /> PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:360-303-5906 <br /> GAG%� CONTACT EMAIL:colep@striderconstruction.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$ ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING: <br /> PROPOSED USE OF BUILDING: <br /> HEAT SOURCE: ❑Gas Vlectric ❑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: <br /> Ski <br /> ACKNOWLEDGEMENT:/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.1 am the owner,or l am authorized by the owner of this property to perform the work for which application is made. <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Z PERMIT# <br /> Owner/Authorized Agent Signature Date (Revised 21812021) ) <br />