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NM 0 <br /> •• BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal cheddist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425.257.88101(E)everetteps@everettwa.gov I.(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 6902 Columbia Ct/Ave PARCEL#: 00580300000100 <br /> cm.Everett STATE WA zip 98203 <br /> SUITE/UNIT#: n.a FLOOR#:n.a ADDITIONAL LOCATION INFORMATION(if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): Chinook NW 2 LLC <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: n.a Lot No.:n.a (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Tyler Auriol-Chinook NW 2 LLC . <br /> OWNER MAILING ADDRESS: STREET 13517 47th DR SE <br /> CITY Snohomish STATE WA „P 98296 <br /> OWNER PHONE:425-293-8343 OWNER EMAIL:tauriot@comcast.net <br /> CONTRACTOR COMPANY NAME: n/a <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ISIOWNER ❑CONTRACTOR D OTHER(Please Specify) <br /> CONTACT NAME: 1 CONTACT PHONE:425-293-8343 <br /> Tyler Auriol CONTACT EMAIL: tauriol@comcast.net <br /> BUILDING INFORMATION <br /> . VALUATION OF WORK:$5O0 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> motion shall include the prevadmg fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING: residential home <br /> PROPOSED USE OF BUILDING:residential home <br /> HEAT SOURCE: ❑Gas '1 Electric ❑Other <br /> BUILDING TYPE:lifSFR ❑Townhouse ❑Duplex CIADU ❑Multi-Family-#Units: ❑Commercial DAccessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction DAddition j)if ❑Repair DT.I. DChange of Use <br /> DModular ❑Portable ORe-roof DExterior Alteration ❑Tank(above ground) DAccessory Structure <br /> ❑Fence over 7ft high ❑RackStorage DPool/Hot Tub DTank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: frame enclose 3 existing door frames <br /> Frame utility closet <br /> replace double 2x6 in ceiling with 4x8 doug fir beam, with 4x4 posts down <br /> 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 <br /> current federal,state,and focal law.The granting of a permit only authorizes approved work and na0livklibns therefrom.Deviations must first be authorized in writing from the <br /> Building OlTieial before being authorized under any circumstance.lam the owner,or I am tielketherF#y the owner of this properly to perform the work for which application is made, <br /> and!comply with h he State . . 18.27 RCWand 296.200A WAG <br /> City of Everett Official Use Only <br /> 04 1 0 `1 n 1 PE T# Osl , <br /> Owner/ !,,, ignature Date (Revised 218/2021) <br />