7008 COLBY AVE 2024-11-01 - Laserfiche WebLink

MI az BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requiremen rileECEOVIETit d nun qf 4p+sZed for:vjew, WASHINGTON then drop off completed application plus all required submittal documents to 3dar Street 2nd Floor Intake Drept$ox. CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I - pfettwa.gpvlpecntits.•.---- Blueor Black Ink OnlPROJECT SITE INFORMATION Y t-:t 7Si � Y Please) r'tr t"'� `:�iiYiT1C,?6 PROJECT SITE ADDRESS: STREET 70C4- �-t(-)L // Cry✓/2 PARCEL#: e�/ / /7 /y�y'�}j ' r- - Q/�6)1Y-'f CITY STATE ` - ZIP / v � � SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): / LEGAL DESCRIPTION for new construction: Short Plat/subdivision: {„L f7/ } P Lot No.: 7 (attach copy of long legal description) , CONTACT INF RMATION OWNER NAME: /6444L J' -''t..W.}4. I 1 -C9 �/�t OWNER MAILING ADDRESS: STREET 4/0 2/ > ��7 �� / // v/j��'(71/�ry� L�f = CITY `�" STATE l t' , ZIP L " �) OWNER PHONE: Gib � Z 6 0�tr 4/3 76 (OWNER EMAIL:P/T 4 `C.4 LG/�CP�V/�'W-// c?/ C x CONTRACTOR COMPANY NAME: Chi'/7' 96?-7-U,- (?tom' - WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: dOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT� NAME: f �( ) CONTACT PHONE: 92 7 6 0- 9'5 76 p/ `"tS )60 �z`" '"/J�/�" I/ CONTACT EMAIL:P L Q/14 LL/ Dt /k7 '/&OoF. IG/iJ BUILDING INFORMATION VALUATION OF WORK:$ /24 0()0 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of a bor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: A// PROPOSED USE OF BUILDING: c-i/ C1 (.2 ,Tc�ryisf t M:2ii-J'> HEAT SOURCE: ❑Gas Electric ❑Other BUILDING TYPE: MSFR ❑Townhouse ❑1-Duuplex ❑ADU EMulti-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): [SrSNew Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ElModular EPortable ❑Re-roof ❑Exterior Alteration ❑Tank.(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: 4 e- � CI4sC)e (2C at. 5Jp✓e� �1-7 i`c� f ' r ,. " 1 ___._.__i ACKNOWLEDGEMENT: 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,a 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 befor eing authorized under any circumstance.I am the owner,or l am authorized by the owner of this ,roperty to perform the work for which application is made, and 1 comply with t e State Contractors Law 1827 RCW and 206.200A WAC. \.......p il ., , City of Everett Official Use Only 2 PERMIT# d � 0 / l — © d 5 OwnerlAuthorized Agent Signature Date (Revised 4/21/2022)