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ILEBUDING PERMIT APPLICATI <br /> r T CITY OF EVERETT PERMIT SERVICESIF <br /> E Y E R E 1 T SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> wAsHINaTON then drop off completed application plus ail required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION: (P)425,257.8810 f(E)everetteps&vereltwa.gov (W)everettwagov/permits <br /> (Blue or Black ink Only Please) . PRRoJECT SITE INFORMATION, <br /> PROJECT SITE ADDRESS: STREET 2932 Colby Ave PARCEL#: <br /> clrY Everett STATE WA 2.1P 98201 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (If applicable): <br /> TENANT/BUSINESS NAME (if non-residential):Golden Smoke House <br /> LEGAL DESCRIPTION for new construction: Short PlaUsubdtvislon: Lot No,: (attach copy of long legal descripllon) <br /> CONTACT INFORMATION: . <br /> OWNER NAME: James Hopkins <br /> OWNER MAILING ADDRESS: STREEr 2926 Colby Ave <br /> ctrr Everett STATE WA ZIP 98201 <br /> OWNER PHONE:425-770-2675 OWNER EMAIL: hopkins1720@msn,Com <br /> CONTRACTOR COMPANY NAME:Davis Door Inc <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):DAVISDS 181 C8 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 025343 <br /> CONTRACTOR ADDRESS; 5ThEET2119 39th st <br /> crry Everett STATE WA z,„ 98201 <br /> CONTRACTOR PHONE:425-508-1506 CONTRACTOR EMAIL:Maxe@davisdoor.com <br /> PRIMARY CONTACT: ©OWNER ❑CONTRACTOR l]OTHER(Please Specify) Assistant <br /> CONTACT NAME; CONTACT PHoNE:360.914-9155 <br /> Ashiie Adams CONTACT EMAIL:goldensmokehouse@gmaii.com <br /> BUILDING'_'INFORMATION <br /> VALUATION OF WORK: $$10,000 !ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (yaluatlrm shall Include the prevalknp fair market value of ail labor,materials,end equipment needed to complete the Work,whether actually paid or not.) <br /> 'EXISTING USE OF BUILDING: <br /> r— <br /> 'PROPOSED USE OF BUILDING: <br /> HEAT SOURCE; ❑Gas ❑Electric ClOther <br /> BUILDING TYPE: DSFR °Townhouse ❑Duplex CADU {:Multi-Family-#Units: °✓Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all Mat apply): ❑New Construction °Addition °Remodel °Repair DT.I. DChange of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tar,k(above ground) °Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage °Poo!/Hof Tub °Tank(above ground) °Other: <br /> DESCRIPTION or wo12K: Rolling steel door. <br /> 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 <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must firs!be authorized in writing from the <br /> 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, <br /> and i comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> }/ City of Everett Official Use Only <br /> • r7 <br /> 1 r� t �j II d� PERW# J ~02]2 <br /> Owrtet.Authorized Agent Signature Date (Revised 2/8/2021) <br />