3230 OAKES AVE 2023-05-19 - Laserfiche WebLink

Elm liz BUILDING PERMIT APPLICATIR 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 3 a3D Oa)PS Sr PARCEL#:00L/3qO (60 Ig J7 CITY A/"f,p t tr 1 STATE lijGi ZIP q O ZV 7J 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:JJr)ni I U,h cram/ OWNER MAILING ADDRESS: STREET TY )3Q30�Oakes f S� ) )/� (X 7�� CI t' e II- STATE Oa ZIP 2 / OWNER PHONE: OWNER EMAIL:CONTRACTOR COMPANY NAME: 4 -f(U1d f(_n &2a.11 al i SI WA STATE CONTRACTOR LICENSE#(REQUI+RED):0,�"Dt.({"5 IDf� CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET I IO11y t )A GU'IYFG Vic 14) DR. 1 �(�`, ICI,, 4/e,Y C 44- STATE i/./0/( ZIP U 20/ CONTRACTOR PHONE:Li LS- f 0-GJ Cr-7.1 CONTRACTOR EMAIL: f l ► lii) 1S e )2eser/A Cli is I. ner PRIMARY CONTACT: 0 OWNER %CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: � CONTACT PHONE: HZS-503- �dc�ta2_ fits I S b�/1 I l� CONTACT EMAIL: (((es ha e i espec,jaiiISt r ri— — ,Jj/�-� ILDING INFORMATION VALUATION OF WORK: $ 3 v(/� 6 `- Q Cai A'+s° ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair ma(ket value of all labo, terials,an equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: S PROPOSED USE OF BUILDING: 019 lain-00C HEAT SOURCE: ❑Gas ❑Electric ❑Other _ IA BUILDING TYPE: rcASFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel OrRepair ❑T.I. ❑Change of Use ❑Modular EPortable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:. ! t �j(,Lrl!"?!�I f-) engineercd pi o�s l y I�c to -�(jwnao�tif-, 1Cl2�SJ1Zi i . 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. City of Everett Official Use Only 1/ 7 I 2 2- PERMIT# F _, ^ 0 45 wnerlAut ri ed Agent Signature Date (Revised 4/21/2022) CZ