1818 RAINIER AVE 2023-04-25 - 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 1 (E) everetteps(a)everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION 7 PROJECT SITE ADDRESS: s tts r 191 n PARCEL #: q /ivZ //�� 7 CRY STATE I) SUITEIUNIT M FLOOR #: ADDITIONAL LOCATION INFORMATION (if applicable): TENANTIBUSINESS NAME (if non-residential): LEGAL DESCRIPTION for new construction: Short Plat1subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: I l OWNER MAILING ADDR S: STREET L a4zeA C Tyy STATE W 1A ZIP 21 OWNER PHONE: ( /J 73 , It mm S OWNER EMAIL: 2 &JILI CONTRACTOR COMPANY NAME:: WA STATE CONTRACTOR LICENSE #(REQUIRED): V iC 83s0CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): Ald CONTRACTOR ADDRESS: STREET y�Z() d/UL Qp�r� CITY /�. STATE ZIP 9Qo// CONTRACTOR PHONE: �0 [," CONTRACTOR EMAIL: t PRIMARY CONTACT: ❑ OWNER A CONTRACTOR A OTHER (Please Specify) =fti CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: 1 n BUILDING INFORMATION r1 VALUATION OF WORK: $ I"' � I'W- ' SSOCIATED LAND USE PROJECT # (if applicable): (Valuation shall include me prevailing fair marks value of a labor, materials, and equipment needed to complete the work, whether actually paid or noL) EXISTING USE OF BUILDING: C PROPOSED USE OF BUILDING: HEAT SOURCE: ❑Gas ❑Electric V ❑OIIT r n 0 n,,, BUILDING TYPE: [PSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT (check all that apply); ❑New Construction ❑Addition ❑Remodel ❑Repair ❑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: 11� DESCRIPTION OF WORK: b�ti u� -ft ~ old WOO/- Cl/L V J�-b nC, {o✓ b�) dj,�Wu-v e`1 rew 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. I am the owner, or I am authorized by the owner of this property to perform the work for which application Is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Agent City of Everett Official Use Only PERMIT # (Revised 2/8/2021)