7004 COLBY AVE 2025-04-25 - Laserfiche WebLink

D ©iv[ .... ,... BUILDING PERMIT APPLICATION (� CITY OF EVERETT PERMIT SERVICES 1 APR"7R 0 3 2023 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 GlI YtrWnfi.Flsepr REk4tfop Box. CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices©everettwa.gov I (W)."sugr�Uyv .gov/{:ericliLs,.,e. (Blue or Black Ink Only Please) PROJECT SITE INFORMATION / PROJECT SITE ADDRESS:� STREET 7 0� Y (,1C,/L "i,7�j C,-t-,z�-E PARCEL#:CI E-///,�(__ : `t' CITY /r STATE W4 ZIP 94 2o SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): /t//- LEGAL DESCRIPTION for new construction: Short Plat/subdivision:COL") Lot No.: 7 (attach copy of long legal description) CONTACT INFO MATION OWNER NAME: p Au- K-oRizo....Jo67/ty OWNER MAILING / Y ADDRESS: STREET y2 .3 /- S - ✓ !/ � /. 2)- /7 CITY STATE tz 4 ZIP ?-?��, � OWNER PHONE: M�Z ) -- Z � ef 3.74 OWNER EMAIL:P4 cri.,.e A Lc/i0 ti/4 p/fir z L014 CONTRACTOR COMPANY NAME: �,t.711` --)z C? C'- ,>/''_ (.2 Ce-7- _ `7 WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: 9 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: ! CONTACT PHONE: -f 2 5 Z- i 0 _._ G/ 3 7,6 P4 V _ icoRx/'4'g l P/ v� L ( i t /i,Q% 7 �- c) CONTACT EMAIL: �� t`�`�'�F cc-,tt,„, BUILDING INFORMATION VALUATION OF WORK:$ / 7-v2( JUC' ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,mat€vials,and equipment needed to complete the work,whether actually paid or not) EXISTING USE OF BUILDING: /1-/ PROPOSED USE OF BUILDING:.�,/ Si %z' f ' /`- C1-isI�1 _r !i/i'JJ2 HEAT SOURCE: ❑Gas E ectric ❑Other BUILDING TYPE: VSFR ❑Townhouse ❑�D,uupplex ❑ADU ❑Multi-Family-#Units: .__ ECommercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): MNew Construction ❑Addition ❑Remodel ERepair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) EAccessory Structure EFence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: i CV P_ Ve. (. c. 7--/-t,A( or q ii,6 /E-711,„ 7p, 2-?e ,- ACKNOWLEDGEMENT:I have revie dis 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. he ranting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being auth ized 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 Co actors La .27 RCW and 296.200A WAC. + �� 7 City of Everett Official Use Only % PERMIT# 32. 3o 1-1. —003 Owner/Authorized Agent Signature Date (Revised 4/21/2022)