1802 75TH ST SW 2024-11-07 - Laserfiche WebLink

Imp WILDING PERMIT APPLICIFON 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 I got 75' ' 54- 5l-i.) PARCEL#: CITY E STATE ( ZIP 98203 SUITE/UNIT#: j 3 (�as FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): 5/10 ko nn,5k Coy,,,` PLO LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: S t'iO/(OM l S H C Dt-LtJT`/ OWNER MAILING ADDRESS: STREET /802 7541 i 5 t,J CITY evfRE /// STATE CADfj ZIP 9eZo3 OWNER PHONE: LI 25— 753-55G 9 OWNER EMAIL: 5K C 5 nO.A.w), coM CONTRACTOR COMPANY NAME: C-.,f2aqJ 1TEC. -5 YSI—s s tN C . WA STATE CONTRACTOR LICENSE#(REQUIRED): GRAULSI 9 7ODS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 000145 CONTRACTOR ADDRESS: STREET 2 ( 29( Lip/DALC RC) k)l,0 CITY POLL Ls ao STATE LADt3 ZIP v 37O CONTRACTOR PHONE: 20(p-7 'O— 289F CONTRACTOR EMAIL: _ 5C `Terse3 c v, f c , c6M PRIMARY CONTACT: ❑OWNER ®.CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 3�0 - 1 1 U Z. CONTACT EMAIL: ��wers* �C0.V�+ec . CaNl BUILDING INFORMATION VALUATION OF WORK: $ 4 4,, Co(p ASSOCIATED LAND USE PROJECT#(if applicable): /vA• (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: if F (-( l G.Li. (J F15 14 l tc)G. PROPOSED USE OF BUILDING: V- f-I- t C L€ LAD f iS t-)/ HEAT SOURCE: ❑Gas ❑Electric ZOther �Pr BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: XCommercial ❑Accessory 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) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub Clank(above ground) 1Other: FALL Pr3o7VcT100 54 Si rnM IA STAG.. DESCRIPTION OF WORK: dock is 4-0l'r.s (a ( I a (o84+ (off r t5 c) raLl sus d esi5r dp F t,,DorleoorS w Goo c- l�,'ti ( of ke ,5�f clQa^ Snol�oM'sl, GO A4-j p t v t? �o / 'S I'n v(Ay.es n 51—ft S; b f•A c �ce �-5 `'(�) 5 UPP a r-/-- G net cvtw�t G-�w e.F% Ct l l 'rV`2 C Z L t d r o�.CJ d 1`G.1� 'Eo r l 5 n6�-P-t�� ACKNOWLEDGEMENT:1 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 PERMIT# F/7/2,3 — 02-7 0 ner/Aut d Agent Signature Date (Revised 9 9 4/21/2022)