2810 COLBY AVE 2025-04-14 - Laserfiche WebLink

.... mi, ILDING PERMIT APPLICA1N 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)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2 (0 5)/(GI v.-4,I/e PARCEL#: Od'( let 16 64 o a CO CITY 0 VC re .-4 STATE LOJ ..- ZIP CM / SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): o`,` (C) Col 1 7 �(....C LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: S k•-e.V C Co rt,-17kS ifie,W v_✓ a.el? CCI[by L LC OWNER MAILING ADDRESS: STREET 1 1 Lit w (-O n 1 pp Jell V e cm" G I){,ter e •k STATE ti.J A ZIP q3.V / OWNER PHONE: (.( )�"a(Q•3 41 7 OWNER EMAIL: S;-Q C 1'-d 4'lt3 Q.4s ncc 4 A C+ CONTRACTOR COMPANY NAME: C. p!e 4.111'0 1 QLu mid (Ls t(A))Al a.WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): • CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: pitWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING INFORMATION av �'VALUATION OF WORK:$ &1 O ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment need d to complete the work,whether ctually paid or not.) EXISTING USE OF BUILDING: C' 1 yll^t C Q I O CAM PROPOSED USE OF BUILDING: 0 �'"." I CQ ( (2-Q,t 1 1 HEAT SOURCE: ❑Gas grlectric ElOther BUILDING TYPE: ❑SFR ❑Townhouse ElDuplex ❑ADU ❑Multi-Family-#Units: ACommercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ElAddition ❑Remodel ElRepair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ,)exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ElPool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: ^ r r KtAv,crut „,..., ,,,,, ,,,, ,,,e,,/, p re I , S �, �l !,,-�CIl cufred- a,whItk AA,c a� -6 p re-t� l � �y,. -LC Y1 • � t $ &A 4 5'.d� b 1 a s-3- 16w aw� d ' 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 Off 'al 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 corn y ith t e aw 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PER 7- /6�- a 2:20g --co2 -- Owner/ thorized Agent Signature Date (Revised 2/8/2021) /y,