3429 KROMER AVE 2023-07-28 - Laserfiche WebLink

f3 DING PERMIT APPLiCATON CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS: See applicable submittal cheddist for submitfat 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) 425.257.88101(E) everetteps@everettwa.gov 1(W) everettwra.govipermits ffline or ** y PJease) JMROJWT =TJE PROJECT SITE ADDRESS: sTREEr 32 k�Yi7 PARCEL'-- My STATE W A- zoP SUITEAiNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION (if applicable): TENANTIBUSINESS NAME (if non-residential): LEGAL DESCRIPTION for new constrxictioric Strait PbUs> iore [A No.: (attach COPY all description) CONTACT'MFORMATION OWNER NAME: i OWNER MAILING ADDRESS: STREET CITY STATE IAJ71 zip C620 OWNER PHONE: ® �� o 01�f1(NEREMAIL- fl a • S� /�—(.711 CONTRACTOR COMPANY AyWA STATE CONTRACTOR #(REQUIRED): $LQ EVERETT BUSINESS LICENSE #(REQUIRED): CONTRACTOR ADORES sTwu C> CirY STATE W 14C ZIP CONTRACTOR PHQ4:2C-)( -7SG CONTRACTOR EMAIL: CtI NARY CONTACT: ElOWNER XCONTRACTOR 0 OTHM (Phase Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: a .BUILDING INFORMATION +"w VALUATIOJV OF WORK: lL V SOCJATED LAND USE PROJECT # Jf pbcabJe : (Valuation shal include the prev al g fair market v ue-of all la or, 1rhaterials, and equipment needed to complete the work, whether actually paidornot.) EXISTING USE OF BUILDING: �j PROPOSED USE OF BUILDING: ® t ,� HEAT SOURCE: ❑Gas XElectric 06ther BUILDING TYPE: XSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family -# Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT (check all that apply) : El New Construction ❑Addition Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re -roof ❑Exterior Alteration ❑Tank (above ground) ❑Accessory Structure OFence over nhiglh iE3Rad6torage QPodt lot Tub .'11Tank(8Wve 9ma ad) 000w. DESCRIPTION OF WORK: No rx� Vial 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. Signature City of Everett Official Use Only PER �ff# •' O (Revised 21812021)