9305 3RD PL SE 2022-01-26 - Laserfiche WebLink

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 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 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 305 3rd ?L SE PARCEL#: CITY EV ere-J STATE V V- ZIP -i 8 2-6 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: V0 \ IOC \e,"OV OWNER MAILING ADDRESS: STREET 30 5 3, PL SE Q 7 CITY Eli ere f STATE IA/I ` ZIP L O. OWNER PHONE: 20 Ia - 334 - g 5 7 OWNER EMAIL: Ivan . koc,In erav e com CONTRACTOR COMPANY NAME: ?r-o rJ e rJ U W�1 e r `}} WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: kiOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 2O(o — 3 3 Lf— b 95 7 v A N 14 O ckeA--c>v CONTACT EMAIL: \J 4 .\G o c.k P..--0'/ @ W'A t 1 -L.i)' BUILDING INFORMATION LE Eli wig r; VALUATION OF WORK:$ ASSOCIATED LAND USE PROJECT#(if ap le): (� (Valuation shall include the prevailing fair market value of l labor,materials,and equipment needed to complete the work,whether actually pad r ) MAY 2 0 2021 / EXISTING USE OF BUILDING: f ..._./_..✓// PROPOSED USE OF BUILDING: S F CITY OF EVERETT HEAT SOURCE: ❑Gas OElectric ❑Other Permit Services BUILDING TYPE: RSFR ❑Townhouse ❑Duplex ❑ADU ❑Mufti-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition S1Remodel aRepair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: e n tY-1 . h uti- , el c c++'',) C-o ( S oU rc t (yte64=4.6n+ c: work -Fur ele curl c s t�rr\a� Frer tt',, Sr-ea and been nspe c sec -fur conk 13Ut1dltr,r _ f-e•m v- oe Soere drt,v✓osM aAcC rein Sitll wt hard;ehctcicer- ane,nrecw.UtreeQ 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.lam the owner,or I am authorized by the owner of this properly to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature Date (Revised 2/812021) I