5311 COLBY AVE 2024-02-09 - Laserfiche WebLink

iamm E QUILDING PERMIT APPLICAON 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 1(E)everetteps@everettwa.gov j(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5 I .!l l PARCEL#: 9030/005450 CITY STATE kiA ZIP 46203 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: L04/1 CPI,O°l OWNER MAILING ADDRESS: STREET , vl I CITY Euterlit STATE tiN/a ZIP 61,6203 OWNER PHONE: ZO6 747 6662._ OWNER EMAIL: SD p 3/ l 6 C COAIL CONTRACTOR COMPANY NAME: HO8y.�(/0 1/ t." 1-/pt WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 3 3 a CITY 6eleirli - STATE Wik ZIP 'b ao 3 CONTRACTOR PHONE: " 711 661)2... CONTRACTOR EMAIL.: G( ?waif-C>,4 PRIMARY CONTACT: t! •WNER El CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 6E4 2, 1144 C -\ CONTACT EMAIL: Jct e ,006,466.1 31 Lf 6 gi.*vii J, BUILDING INFORMATION VALUATION OF WORK:$ 4300 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: FP PROPOSED USE OF BUILDING: S F R P�7 HEAT SOURCE: Gas PElectric ❑Other BUILDING TYPE: LV S4FR (Townhouse__❑Duplex- DADU DMulti-Family-#Units: DCommercial DAccessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction DAddition ❑Remodel DRepair I.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) i❑Other: DESCRIP�PiOF WORK: Q'„ Z'�'ISC.O P t & k 0b/—&r )nt 5 O 'az) 1 Yr.� r —"' Rp �u rr�i i. e,�'lSu�w� l r'> s w;411 A-6,9 A.Ag , 0F2,/os -on) c,o,�b � *�pC, f-eo� 0,4� +tea-ce, �. -�,� zc�.�r� WO Vd ZV Fndv-A p �x Pt DC 0 x 2` w;'14° 'A P swx 3e &reel -{1' as ✓�t��.( s - s-�,-v�-ca 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 lam 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 17/. 6/ o/zot PERMIT# _Owner/Authorized Agent Si nature g e (Revised 2/8/2021) r 12