2003 WETMORE AVE 2023-08-24 - Laserfiche WebLink

:D ECEOVE 9 BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES fV)AY 2 3 2023 E V E R E T T 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 Sevp" I3PFr I�VEREOPT CONTACT INFORMATION: (P) 425-257-8810 1 (E) PermitServices@everettwa.gov I (W) everettwpWyM[�nLa-, ,;T (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET c3 0'3 �• PARCEL M CITY - _V �Q STATEwPl:ZIP SUITE/UNIT M FLOOR M 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:, LIN M OWNER MAILING ADDRESS: STREET �'v1g CITY wL'O'IW STATEJ pt ZIP t?Y� OWNER PHONE: `ZO •. j OWNER EMAIL: •Z 06 3 V.i C—\ i; "Ove tM U C61'h CONTRACTOR COMPANY NAME: Jh WA STATE CONTRACTOR LICENSE #(REQUIRED) TY OF EVERE USINES LICENSE #(REQUIR D): C NTRACT RO AD,DRESS: STREET Z Cj ZJ niU �aZ J CITY b STATE ZIP ALTRACT�NE: — 2 CONTRACTOR EMAIL: m PRIMARY CONTACT: IgOWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: %i N �M CONTACT PHONE: Z;m(j lq S` CONTACT EMAIL: .Z �,v i,a iMO"YZ tMk l , CJYO BUILDING INFORMATION VALUATION OF WORK: $ Sc' �' �— ASSOCIATED LAND USE PROJECT # (if applicable): (Valuation shall include time prevailing fair market value of all labor, materials, and equipment needed to complete the work, whether actually paid or not.) EXISTING USE OF BUILDING: PROPOSED USE OF BUILDING: HEAT SOURCE: ❑Gas MElectric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse 11Duplex ❑ADU []Multi -Family - # Units: []Commercial ❑Accessory Structure TYPE OF PROJECT (check all that apply) : ❑New Construction ❑Addition ❑Remodel FqRepair ❑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: DESCRIPTION OF WORK: �� r 'V 8 Y VJ 'A i-- V A,-VkQ11C- `F +CY�RM C d`�l t Y\ e 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. / am the owner, or t 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 V PERMIT # • 16 t `z3 ,�— Vic' Owner/Authorized Agent Signature Date (Revised 412112022) �5 C cy?;l