1502 WALNUT ST A B 2024-05-03 - Laserfiche WebLink

ism BOLDING PERMIT APPLICATItt 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 I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET t t22 With-.JvtV StY PARCEL#:17fie'Dot(3K3434v�4-c,I CITY J �7 STATE WA ZIP "l`?Zu( SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): -A/Ni , 1.+ n ,>' n os n'L LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: t \A'A► §AT St/ LLC — WA OWNER MAILING ADDRESS: STREET 1 2 VlL '.AVo/,p}' ? i �r cm T71!ice t--L A STATE w✓� ZIP OWNER PHONE: (-41) '/1- f OWNER EMAIL: Gt beq.t4.1-t ht I(% V, 4_9 wvt,l� l c,c;, u,,,, CONTRACTOR COMPANY NAME: OWv4e.2/e7 V- Y,/s l-f-•=.5 • 1r WA STATE CONTRACTOR LICENSE#(REQUIRED): u/1F- CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET -1 CITY �� a a �/V c�c� ,7 STATE W4- ZIP L v - F- CONTRACTOR PHONE: C 4- 1-1---6,tt Zc}- CONTRACTOR EMAIL: Wiz, PRIMARY CONTACT: ICI OWNER ❑CONTRACTOR q0THER(Please Specify) A A-ra toe CONTACT NAME: chrtite-L. ,/, `�trlsc�S JYL CONTACT PHONE: (?p()) 4.-t - i 5 ) 7! ' Cp C 2-4 CONTACT EMAIL: BUILDING INFORMATION VALUATION OF WORK:$ `/''d C,v 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: GNLs rl�Cz 1P t 2vtrt u�Fn./Qy-5io y.r 1^�.tt�o�a Tn ,ram 42"eLAal PROPOSED USE OF BUILDING: Co.;JAli- ��C� G��+"` �?' `5� 1�' ak-+ N 4- P..t �t HEAT SOURCE: ❑Gas EElectric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse I4Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ElAccessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ®Remodel ❑Repair ❑T.I. EChange of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) EAccessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: t.1 v t: --t-- K - L /' 5 ••-4.11-V '3 to( tV,t JL -ram 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. City of Everett Official Use Only /`�`/210 �2 PERMIT# 17� 4n wner/Authorized Age Signature Date (Revised 2/8/2021) i�