1818 RAINIER AVE 2023-04-25 - Laserfiche WebLink

EM►-e-d BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required far 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@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION l' PROJECT SITE ADDRESS: STREET 0 � (� A A h•P PARCEL M M1414 Y;;In 2'37-73oc7 cm STATE ZIP SUITENNR #: FLOOR #: ADDITIONAL LOCATION INFORMATION (ff applicable): r rNAN I IBUSINESS NAME (if non-residential): I LEGAL DESCRIPTION for new construction: Short Platlsubdtvislon: Lot No.: (attach copy of long legal description) CONTACT INFORMATION VNER NAME: VNER MAILING ADDR S: STREET o n/ Cm STATE ZIPVVNER PHONE: ( , '-T: " , W OWNER EMAIL: 2 M C,0 onou Q --------------------- ONTRACTOR COMPANY NAME: VA STATE CONTRACTOR LICENSE #(REQUIRED): oMWf EVERETT BUSINESS LICENSE #(REQUIRED): ;ONTRACTOR ADDRESS: STREETca CITY STATE ]gyp CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑ OWNER A CONTRACTOR OTHER (Please Specity) CONTACT j CONTACT PHONE, - v " t/`�/` t1+lti CONTACT EMAIL: n �y BUILDING INFORMATION VALUATION OF WORK: b 1 {� lrit� Valuation shall inGude the nrn�n�n,.,, ram:...._..- ,.. _ .. - SSOCIATED LAND USE PROJECT # (if aoolicahlal• - - -- • --_-� .v V,.„N== � = w K, wnemer actually paid or not.) EXISTING USE OF BUILDING• �� "t.C..i PROPOSED USE OF BUILDING: HEAT SOURCE: ❑Gas ❑Electric V ❑Oth r_ 110y1�� BUILDING TYPE: gSFR ❑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) ❑Accesssary Structure ❑ ❑ Fence over 7ft high RackStorage ❑PoollHot Tub ❑Tank (above ground) ®Other• (1 ilIt,' �Q DESCRIPTION OF WORK ' &v- bowvww) driw'al "P ) I 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 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 1 am authorized by the owner of this property to perform the work for which application is made, and I comply wUh the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT # m4ner/Kuthorized Agent Signature Date (Revised 2/a/2021)