4602 COLLEGE AVE 2025-04-14 - Laserfiche WebLink

ull BOLDING PERMIT APPLICATI. 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 r�ro /! ,'prY PROJECT SITE ADDRESS: STREET 4-Cin2 CoIkecce !ZsiL PARCEL#: Ob412OU®2.J3`�OO CITY C..f -&"k-T STATE w(\ ZIP CI,32.0 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: .,1/4AV1t1/4(/‘ W k, {-e OWNER MAILING ADDRESS: STREET 1 19 02 Cal►tile A 7CITY E vt,sa;k J STATE e ZIPCCK`U 3 OWNER PHONE: '4,-I't='r) 1 S '3 q\ OWNER EMAIL: ,_,CShW�vv&tT ,�(, T"r•Lk \ , CC"I CONTRACTOR COMPANY NAME: WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: d OWNER [ ONTRACTOR _DINER (Please Specify) CONTACT NAME: CONTACT PHONE:4-2 Si—2 7 5 w-Si lc 0 JQ \G \j( CONTACT EMAIL: `f hVvh6)-et.3ca� ltirn‘I..e°l"\ BUILDING INFORMATION VALUATION OF WORK: $ 4/00 C� ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fai market va ue of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: PROPOSED USE OF BUILDING: HEAT SOURCE: 3as \llectric )ther BUILDING TYPE: <,:,-,FR ownhouse duplex F,DU lulti-Family-# Units: .ommercial ,ccessory Structure _ TYPE OF PROJECT(check all that apply): lew Construction _,ddition I->Femodel I repair F LI. hange of Use _lodular portable ,e-roof 7Ixterior Alteration ank(above ground) ,ccessory Structure ence over 7ft high ackStorage ool/Hot Tub ank(above ground) )they: DESCRIPTION OF WORK: I,, 1\e0,V“V\ \C t1(\i kUVbelLvv\vcr t \s 6 O Fur s\C cAvvk eX, I t hesimakiKktcr,A cur C '- ' w(^kr w-13 l' 1 pA Unck thrall ku- i- hcl)s e,3\11A1 i‘) v1- \x\ (MP q Pe,11 VKN.. M e n V :' V V bc>\}h is",,,\ 0t'& N cc re,c} vvc^s\f\e+rIt)r7cr to svv\-zi -i 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 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./ �1 �Citty of Everett Official Use Only /� G Date �L2 - PERMIT# 1 l o5+O P l/ O / uthorized Agent Signature Date (Revised 4/21/2022J