3332 COLBY AVE CALVARY BAPTIST CHURCH 2025-06-09

LI Bl'-- DING PERMIT APPLICAT' -4 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 3332 COLBY AVE PARCEL#: 00436979001700 cir EVERETT STATE WA ZIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): CALVARY BAPTIST CHURCH LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: 17-21 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: CALVARY BAPTIST CHURCH OWNER MAILING ADDRESS: STREET 3332 COLBY AVE CITY EVERETT STATE WA ZIP 98201 OWNER PHONE: OWNER EMAIL: ��e CONTRACTOR COMPANY NAME: t')n. � ?SA-Cco D Z� ,? ..., WA STATE CONTRACTOR LICENSE#(REQUIRE f T GM, TY OF E RETT BUSINESS LICENSE#(REQUIRED) CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) ARCHITECT CONTACT NAME: CONTACT PHONE:425.377.H7H6 MARTIN RE I M E RS CONTACT EMAIL:MREIMERS@CONCEPTARCHITECTURE.COM BUILDING INFORMATION p WO VALUATION OF WORK: $90,000 ASSOCIATED LAND USE PROJECT#(if applicable): w LZ"��U- 4 (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:CHURCH C�/'a-ov&, PROPOSED USE OF BUILDING:CHURCH HEAT SOURCE: ❑Gas ❑Electric ❑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 ❑T.l. ❑Change of Use ❑Modular ❑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:THE PROJECT WILL CONSIST OF A NEW 764SF ENCLOSED ENTRANCE. ACKNOWLEDGEMENT:I 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 I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 7,)d-Aieoezi.e....d.._:___ 9/21/22 P RMIT# I 1 22U "Doi- ] Owner/Authorized Agent Signature Date (Revised 4/21/2022)