1314 E CASINO RD 2024-06-12 - Laserfiche WebLink

ism BUIONG 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.govlpermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET l 3/1 G- :- PARCEL#: >ei r Li a ( r STATE vl//1 ZIP /!�r 2 c 3 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: t,7E . i S,r H.,2/-2 41c Y /4/2 f/ /� /�/✓U 5 OWNER MAILING ADDRESS: STREET I /'v' L, C 9 5/ /Q.D. Q X CITY Vel2 Ic r/ STATE 1.'✓✓T ZIP 9Q,J7t) OWNER PHONE: 62.53 i 7 - / oZ S OWNER EMAIL: t////‘=_' t/ y (7 j7,C S T, j CONTRACTOR COMPANY NAME: 1-4 44,g 126 .'vO ✓.•9 T/o.,v L L WA STATE CONTRACTOR LICENSE#(REQUIRED):L4 M/j(Z/CL 7$0/06, CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET /0 / sT 377.. 7 n /� CITY S.N6 i --"7/ S/7' STATE (/I-/Y ZIP 9C)?-%C CONTRACTOR PHONE: (L1��) 57.9. - CONTRACTOR EMAIL: Jy; L A/Y/ ,49 --PIP- PRIMARY CONTACT: ❑ OWNER I2 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: j / CONTACT PHONE: (4/02 ) s-/02 - 47/06.14 yrt CONTACT EMAIL: J uSTiA/ a 1-A 4)c BUILDING INFORMATIONfi VALUATION OF WORK: $ / L. C ( c ASSOCIATED LAND USE PROJECT#(if appli b )E JL (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or n EXISTING USE OF BUILDING: S F2 JAN 23 2024 PROPOSED USE OF BUILDING: S f i` HEAT SOURCE: i0Gas ❑Electric ❑other CITY OF EVERETT BUILDING TYPE: �SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial RLJAccet sSoryl5tn7cA TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ETA. ❑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: /UoA/-- LOi90 - i=/1/2i it/G 4.H4AJ E S : c K °9..vD Gov /P/aY /Ze90.44 C H4 1Gk' peke LOLAr,oA/ /yam ©`1 /LIMO✓t a,47-f-/ /Zvo CLOSe�T. v2 F4 Lt S : vPQ.4TC FL oO2 i Ai a, // -v-046/t e0/9,,1.7; ' ' - i..t.O 'c t-C`172 I Gz9l ar P FMB r,?PO,47tS su;u - -2qC rc 'S ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursdh 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 PERMIT# Owner/Authorized Agent Signature / to (Revised 4/21/2022)