4302 RIDGEMONT DR 2025-08-15 - Laserfiche WebLink

r mei Liz BUILDING PERMIT APPLICATIUN ECEOVETh., CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements umb1ARopHreJ 1 for re tit , WASHINGTON then drop off completed application plus all required submittal documents to 3200 e r Street 2nd Floor Intake Drop-BCx. CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(W)evg�it pv/per�ti /is, TERETT (Blue or Black Ink Only Please) PROJECT SITE INFORMATION 1.Permit ServicesC PROJECT SITE ADDRESS: STREETf p Jj G 12,d y i; p,,/T ,Pr-,c/z PARCEL#: OC T e Li 7000,078O0 CITY ( L 1/c.b-�,r7 STATE 1,4./4- ZIP 7ej..2,c0 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) �J / CONTACT INFORMATION OWNER NAME: 'J A-y„ �S L i s r/ jZ -' OWNER MAILING ADDRESS: STREET LI 3 lie,0 f cif,.4 r , 2.a07r- U/E j(/ - CITY rC(/r STATE cij A- ZIP 79z^ ?,J OWNER PHONE: OWNER EMAIL: V [Ai „ i..4 I5 ri ci ,,,,i60 spy,gj(. co," CONTRACTOR COMPANY NAME: ..5A-17 C /-}-_s 0 kj ivc� / WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: Er OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: -5A .6i E /4-S (I r.J,ve/Z CONTACT EMAIL: BUILDING INFORMATION VALUATION OF WORK: $ lj~ 0 O O ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair maret 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: NSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessary Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use LiModular ❑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: C- 0 Al i5 T72, f/ c-,-)" A)6--pi,,i De-c_/..___ j (LETLALE upp.ssbc,(,3 ,-;-)( Li 61 (_a r6bb(._ rr.., .106om A- EC)‹. ({...eA ?6i2 coo i,re g.- /kr-c,) 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# D 33 er/Authorized Agent Signature Date (Revised 2/8/2021)