626 WETMORE AVE 2023-06-23 - Laserfiche WebLink

B•DING PERMIT APPLICAT4IpN 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 k.9 We \ (Qi PARCEL#: 6O496%1a9O1100 CITY `-AV e_\)0LA STATE VI ZIPcit3ai SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): 11 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: F al,,c‘1Qussee_, OWNER MAILING ADDRESS: STREET t,Q 1t \Azie iy Rea, CITY N�\1��. STATE\ ZIP"' a OWNER PHONE:42j ckayt.'4 OWNER EMAIL: �u,SLOt C SS-ee, /I ii I L C CONTRACTOR COMPANY NAME: L FC &3 Y WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: OWNER CONTRACTOR )THER(Please Specify) CONTACT NAME: CONTACT PHONE: 1.12 - Z aO --?L y l-{ Ste- C c jause CONTACT EMAIL: 5.Ci3 A,S S LC cis) 1,44 o Cs�t1"N- BUILDING INFORMATION VALUATION OF WORK:$ 16 0O ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Si 1. PROPOSED USE OF BUILDING: Sif HEAT SOURCE: ;as lectric )()ther aS€ BUILDING TYPE: \IN:FR ownhouse >uplex [IDU lulti-Family-#Units: :ommercial ,ccessory Structure TYPE OF PROJECT(check all that apply): lew Construction 1ddition emodel ■epair .1. ;hange of Use lodular ortable le-roof .xterior Alteration 'ank(above ground) [accessory Structure ence over 7ft high tackStorage ool/Hot Tub ank(above ground) )ther: WORK:DESCRIPTION OF �Q 10d be ens a ca spa i sues s ut \a.\ Jr WYt\y\ock i o iyuatl t cr wf 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 PERMIT# 2_20 5 � 9 a�� a 4hoak/ d Agent Signature Date (Revised 4/21/2022)