2923 COLBY AVE 2024-10-24 - Laserfiche WebLink

NNE BWIDING PERMIT APPLICATON 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 Z423 GOt.-gyAre PARCEL#: b0(.O11111?,93O0goo c�/� crY -EVE 26Tt� STATE 11V r A- ZIP .g 2-e) SUITE/UNIT#: IJ/a- FLOOR#: pt`h ADDITIONAL LOCATION INFORMATION (if applicable): A/OiA TENANT/BUSINESS NAME(if non-residential): 1" '-E /Q/ M1{-if Pog LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: iv V L.0 I N rMEIJ-r5 LLG OSaeQY i _pca1>Ect So VLE OWNER MAILING ADDRESS: STREET 241 2 3 Gpt. QY PritE CITY L I/E-c2 rl- STATE WA-1 ZIP OWNER PHONE: OWNER EMAIL: -�"'11.�j f CSI1 rv1_Cn put @ yt kl o. et)tN CONTRACTOR COMPANY NAME: 1 g t2 1f'it5 r O Gk CO YiS tYV1,(/16 On WA STATE CONTRACTOR LICENSE#(REQUIRED):UJ EST fp,C L s "3--Q K CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): tP I g$3 CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR OTHER(Please Specify) 2£1 Z A 2e- t1 r crU P CONTACT NAME: {i Aim S G 1412.Ete S CONTACT PHONE: Atz S- 2552. -2 15 3 CONTACT EMAIL: Alzt, t s Q 2PI2 ✓ram:.I-rl-k - - 1 B ILDING INFORMATION VALUATION WORK:$ © ' ASSOCIATED LAND USE PROJECT#(if applicable): t.) / a (Valuation shall incl e the prevailing fair market value of all labor erials,and eq ent needed to complete the work,whether actually paid or not.) EXISTING USE OF • pr rl N(,y PL-Pvc.E — RV-srA.,J 2A-14-r/POa PROPOSED USE OF BUILDING: ND G IaoJCa� HEAT SOURCE: ®Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: 'Commercial DAccessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage DPool/Hot Tub ❑Tank(above ground) DOther: DESCRIPTION OF WORK: .)b'wt., IP411) via- FWol2 OF "r tR C. $vIt.Otll./fs r✓'eoIMF OF Wdr2K LImIT6p -re-t4ArO.tT 1MpI204C -4.1r OF 1 ( W. 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 Owns Authorized Agent Signat Date (Revised 4/21/2022)