914 90TH ST SW 2025-01-14 - Laserfiche WebLink

BUDDING PERMIT APPLICATION 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 1(E)PermitServices©everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET C I t� 'i 0 c r c ►J L%v 1 I� t4/1"rPARCEL#: CITY GV L Q-CPT T STATE WA- ZIP q 8.2 arIt- SUITE/UNIT#: t FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): )/p. TENANT/BUSINESS NAME(if non-residential): I v l� IY IA A F 1-) Ir L (- LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: N/m (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: I r lP%Li-1 L E r-vl 1� P' I idu S / OWNER MAILING ADDRESS: STREET (`:L! Dog A 5 W f p I W CITY v!/`� W U 0 STATE LAI" ZIP ig 3 OWNER PHONE: al 5 C -( a - 94-9i4- OWNER EMAIL: rri a L Le.rY1€r rxs 9 9 i-nct i L tFiM CONTRACTOR COMPANY NAME: L Li'JC €r( (r A' LV n 5 t Vv c_t a o r LA-- WA STATE CONTRACTOR LICENSE#(REQUIRED): (: 0 341 Q q .1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 3 Q 5• AvV t'►,,'1 lit S CITY e(�t3C.ie. STATE Vs.] ZIP ZIP g 1 1,43 CONTRACTOR PHONE: a Q(j-- 4 ra _ 04. 1q CONTRACTOR EMAIL: lkcir Lgbvr i v k lot hoc.) PRIMARY CONTACT: Fja'OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: t,0,5 - (, - L i 1.€,1' ` a ` CONTACT EMAIL: (U,Ls : n'Ne.Y'% ol/F1$ a 91Y"011L (rym BUILDING INFORMATION VALUATION OF WORK: $ I Of 4 U 0 ASSOCIATED LAND USE PROJECT#(if applicable): (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: 5 FR PROPOSED USE OF BUILDING: Actii F(AM 1 L%J W J m(? HEAT SOURCE: ❑Gas VElectric ❑Other BUILDING TYPE: ®SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair CIT.!. 12Change of Use ❑Modular ❑Portable ORe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Chang. 400rs t Met recj rMen is . D t ©t DV AokiEf). to;Let yrab b�r� MAY 10 2024 CITY OF EVERETT Permit Services 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 1 am authorized by the owner of this property to perform the work for which application is made, and I comply wi e Sta Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# ^ 0 5- O^ 5 I � L L OwrTei/Authorized Agent Signature Date (Revised 4/21/2022)