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BUILDING PERMIT APPLICATk..d <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 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 3003 West Casino Rd PARCEL#: 28041000100200 <br /> crT' Everett STATE Wa ZIP 98204 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): Boeing <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing Co <br /> OWNER MAILING ADDRESS: STREET 3003 West Casino Rd <br /> CITY Everett STATE WA ZIP 98204 <br /> OWNER PHONE: 425-220-2947 OWNER EMAIL: eric.s.epstein@boeing.com <br /> CONTRACTOR COMPANY NAME:SKANSKA USA Building, Inc. <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):SKANSUB985RT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 044389 <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE CONTRACTOR PHONE: CONTRACTOR EMAIL: stIE <br /> PRIMARY CONTACT: D OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> 1 : 1 ■ <br /> CONTACT NAME: CONTACT PHONE:425-220 2947 Eric Epstein CONTACT EMAIL:eric.s.epstein@boeing.com ciT'( OF VER <br /> BUILDING INFORMATION <br /> Permit s%-rvt ET� <br /> oes <br /> VALUATION OF WORK: $5000.00 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: Manufacturing <br /> PROPOSED USE OF BUILDING:Manufacturing <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: <br /> 737 N. Line 40-25 Tower Relocations DP 40-26.07 includes reconfiguring shop areas <br /> on the 40-25 4th floor. The work includes relocating/installing furniture and some small <br /> equipment relocations. <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 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Digitally signed by Eric Epstein, PERMIT# <br /> Eric Epstein, 276672 276672 67In <br /> Date:2024.05.08 06:58:44-07'00' "I <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />