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Bl "".DING PERMIT APPLICAT` NN <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <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 2300 MERRILL CREEK PARKWAY PARCEL#: 28040200300200 <br /> /j�J/GLC nIc u.� �Q,vTU! T EVERETT <br /> STATE WA z,p 98203 <br /> SUITE/UNIT FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):ZAP ENERGY <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:ZAP ENERGY JASON CLEMMER <br /> OWNER MAILING ADDRESS: STREET 2300 MERRILL CREEK PARKWAY <br /> c,T, EVERETT STATE WA z,p 98203 <br /> OWNER PHONE: OWNER EMAIL: Jason.clemmer@Zap.energy <br /> CONTRACTOR COMPANY NAME:TRICO COMPANIES <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):TRI000L8860H I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: sTREET15066 Josh Wilson Road <br /> clTr Burlington STATE WA zp 98233 <br /> CONTRACTOR PHONE:206.399.3917 1CONTRACTOR EMAIL:Jason@trlcocompanies.COm <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:425.317.8017 <br /> Sandra Higgins CONTACT EMAIL:sandra@a caparchgroup.Com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $50,000 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:off ice/manufacturing/warehouse <br /> PROPOSED USE OF BUILDING:no Change <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:Construction of load-bearing and non load-bearing interior partition walls to create one <br /> (� new room within existing conditioned space, with suspended rid acoutical tile ceiling, <br /> /�l GG2N l�(nti g p p g � <br /> installation of door and frame to new room. <br /> YDOV" 3b� <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 I am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 c y with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 5.1 9.23 PERMIT# k. � — ?/, <br /> cz C)5--- D <br /> Owner/ z t g ture Date (Revised 412112022) <br />