2105 MCDOUGALL AVE B 2025-08-12 - Laserfiche WebLink

Imo BIDDING PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 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 2IO 5 MC--t:�,(7cc,� r4V� PARCEL#: / '-tt i CITY Ev-c-C-' v V'A STATE WA ZIP 5 gzo 1 SUITE/UNIT#: j FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): , TENANT/BUSINESS NAME(if non-residential): ECEIIVIE -- i LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: W h copy ::.;,y,cyai aescnpuur., CONTACT INFORMATION ' APR 3 0 2024 .A OWNER NAME: `-1 rJ/r:�) .), H t - �' CITY OF FVFRFTT OWNER MAILING ADDRESS: STREET /it2)0$ SOnvty$fc�.&. 4'V:e_ Al / Permit Services CITY :.�- 11 / ST E 1414 ZIP 7g/33 OWNER PHONE: 206 "& --VC F OWNER EMAIL: hed.Pgi't/ri{ii gy 9f-14( /. coil CONTRACTOR COMPANY NAME: lJ CI ,3 1.A.Pr/uo/ Li-C. F WA STATE CONTRACTOR LICENSE#(REQUIRED): R6i0 FD LG`3O IC., CITY OF, Ev ERETT BUSINESS LICENSE#(REQUIRED): / / CONTRACTOR ADDRESS: STREET j 03 SLr/v1,V51c, 4i/c_ ,!" CITY S{?CC l/1,_ fr_ STATE �ill ZIP 7gI33 CONTRACTOR PHONE: Al-(p -cz'/07- CONTRACT9M EMAIL: bet.kpari-r 74,ij stweer/•COn7 PRIMARY CONTACT: OWNER El CONTRACTOR ❑OTHER(P ase Specify) '/ CONTACT NAME: CONT CT PHONE: 7„Q(0- W SI -.S'7 0 .44 /M k- CONTACT EMAIL: '( e � BUILpING INFORMATION VALUATION OF WORK:$ vl ', ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,mas,aAdJequipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: Dom'p X / PROPOSED USE OF BUILDING: Coviv-s f- not./-tear %:'+^i iv-5 d,;f i�X +0 I print C-i Pk On i f Lnrtc( 2 AIJ(i5. HEAT SOURCE: ❑Gas ®Electric ❑Other BUILDING TYPE: E SFR ❑Townhouse ❑ plex C\DU ❑Multi-Family-#Units: ❑Commercial ❑Accessary Structure TYPE OF PROJECT(check all that apply): New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. &Change of Use ❑Modular ❑Portable ❑Re-roof ❑ xterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: dvr 21 t7 t I�ctl�u Av`t. - (ovtvc.r-t' S'�;1 i Ir.A.ir-..) A { , i r{. Vt Oct ca, rw. fr cd;,,p le_)( }t, P` l��c('pi� U' •4 (FLo0r- l) and 1 ADDS (FL ocs 2 t- ac- ewuti), Nt, G ., t ,K. i.47(Un;� ; isi(' f Is Dc v l�E- s V/ ''. ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant his 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 b uthorized 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"e t work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. .,r Everett Official Use Only ) �� w � L— N ' off,0 ner/Authorized A ent i na urf re9 9 ate (Revrsad 4/21/2022)