1030 E CASINO RD 2024-01-08 - Laserfiche WebLink

E BUILDING PERMIT APPLICATION 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 to 3b t c....r.vs.ikyoQ 0 PARCEL#: CITY %Y t_pipvSTATE j r ZIP CIS 2,Oa SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATIONINFORMATIION (if applicable): TENANT/BUSINESS NAME(if non-residential) OxsC 0.d.L \R e Lk) P f Q sbkf te. ti 0.1t1 CA r GIB LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.:`'Y (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: �A C+V, 'C_C{,\Sces( OWNER MAILING ADDRESS: STREET CITY STATE r+� ZIP s ',OWNER PHONE: itic. 1 - j 13 N OWNER EMAIL: Y 1..# i c 4\Cet @ S C ck . C Q M CONTRACTOR COMPANY NAME: Tv,.v_ o L3 CO N&-re,vc-r Oki SEtzvi f F S ps WA STATE CONTRACTOR LICENSE#(REQUIRED):sp.S eNy_y506 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):(p(D 615 CONTRACTOR ADDRESS: STREET 4 21( fa2,-L Ir‘a r L hj S.,CITY M( J t ` `(J 4 STATE WA- F" .ZIP 18 r `,, CONTRACTOR PHONE: LA rj —© CONTRACTOR EMAIL: f t } %L PRIMARY CONTACT: WNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:14.s-) S ti d 3 0 al(1[ti 70 h 1 (.` CONTACT EMAIL: rv.tA.sklhnt to to Act rutff w,te dV l t e&a q + ,1. J ta1M J BUILDING INFORMATION krigatmiewmtventufv.41/ 15 0 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: ON)` )r Cal PROPOSED USE OF BUILDING: HEAT SOURCE: ❑Gas ❑Electric ❑Other ��,,�- BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: tidGommercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable 62Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: -1:e..Ovr o c-+" oL s4-i n, o k ok ¶.Oa c-- c Nvok 1hs-ku 1� AL W roo- v t 4-h 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.lam the owner,or!am authorized by the owner of this property to perform the work for which application is made, and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only wne tho PERMIT# K./ 3 I `' k, , Io [ I ?e3 rized Age a re` J (Revised 4/21/2022)