4721 BAYVIEW LN 2024-10-24 - Laserfiche WebLink

11111111 LDING PERMIT APPLICA 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�In47 2/ Vm V,f6'wO L W PARCEL#: 00 4(7D 0 bW O 0 ) / CITY �/vo.c STATE tv 014 - ZIP 7f 2 !/V 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) .p CONTACT INFORMATION OWNER NAME: r YId q W W,P50/ /fi OWNER MAILING ADDRESS: STREET L( 72, 1 4A-y VLe w e-, 4 ,/CITY WOCl .- STATEh YV Pr ` /� ZIP /g20 3 OWNER PHONE: 2 O C"77V"9®O 4)-- OWNER EMAIL: 1 /�1✓11/K7i4'T 131�9. @. 4101-17- CONTRACTOR COMPANY NAME: 0 W h L C WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: VOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:I V V �?IA/ ��s✓Vj)q p 7- CONTACT PHONE: 2 ® G--7.1Q- q v® 2- CONTACT EMAIL: /y,1Idv/ ,v,ttor13 d ,' 'tIt,cern BUILDING INFORMATION VALUATION OF WORK:$ 1 V 000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair mart value of all labor,materials,and equipment needed to complete the work,whether actually paid or not) EXISTING USE OF BUILDING: R C4;bi 4t7 L PROPOSED USE OF BUILDING: / I f T/9 flti hL HEAT SOURCE: LIGas [Vlectric ❑Other BUILDING TYPE: [ SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family #Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition likemodel ❑Repair ❑T.I. ❑Change of Use DModular ❑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: �p�' ')��.�/� ///`/ J�rJ_ ////�RCie,z '/ Y .Fi► nifJc' 64,24a Ifl,9 1))V t' pv 2 A;IIY5 A D0 64TI9R44m 7 v eRfc x 4y p E C .1 6 Golfe dAt 10d NOV 2 7 2023 CITY n1 r°\/FRPTT ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done purst.lanar rXWe'grtfernhi CASy 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 BuildingOfficial before beingauthorized under any circumstance.I am the owner,or I am authorized by the owner of this property toperform the work for which application is made, P P pP and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 049'Sit 06 7 • Authorized Agent Signat. e Date (Revised 4/21/2022) IA) aog