802 E MUKILTEO BLVD 2025-04-16 - Laserfiche WebLink

NMI B•DING 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 I (E)everetteps@everettwa.gov I (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET FOREST PARK 802 E MUKILTEO BLVD PARCEL#: 29053100200100 CITY EVERETT STATE WA ZIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential):COE PARKS DEPARTMENT LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:CITY OF EVERET PARKS DEPARTMENT OWNER MAILING ADDRESS: STREET 802 E MUKILTEO BLVD clTv EVERETT STATE WA ZIP 98201 OWNER PHONE:425-308-3939 OWNER EMAIL: BCHENOWETH@EVERETTWA.GOV CONTRACTOR COMPANY NAME:TBD I r` yva, (day` WA STATE CONTRACTOR LICENSE#(REQUIRED): r�I�G lti(r g(o (( C) CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: 0 OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify),. CONTACT NAME: CONTACT PHONE:423-308-3939 BRAD CH ENOWETH CONTACT EMAIL:BCHENOWETH@EVERETTWA.GOV BUILDING INFORMATION VALUATION OF WORK: $63,000.00 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: PROPOSED USE OF BUILDING: 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.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) EAccessory Structure ❑✓Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:Installation of the following around existing satellite parking lot within Forest Park: 250 If of 8ft chain-link fencing (1) Pedestrian Gate (1) Automated Auto Gate 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 Brad Chenoweth o191r,IIy signed by Brad Chenowe[h PERMIT# Date:202200.0I12:03:32.07'00' 2 Z O 4 - 0 6 `^ Owner/Authorized Agent Signature Date (Revised 2/8/2021) //