7002 COLBY AVE 2025-04-25 - Laserfiche WebLink

I NMI tall BUILDING PERMIT APPLICATION D EVEWE CITY OF EVERETT PERMIT SERVICES r't 7�(C�� , ! EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirement numtAPRcc4ia rd for reIi , WASHINGTON then drop off completed application plus all required submittal documents to 320 C ar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I (V ygcerfet�Io�cgolipettrTit ET i (Blue or Black Ink Only Please) PROJECT SITE INFORMATION Permit Services PROJECT SITE ADDRESS: STREET 7 00 a_ CLP4/67 PARCEL#:///�j�J j } (c t /�- 111 CITY STATE Vf�-�}- ZIP 961 ""V SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): /l -TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: ' 2L S Lot No.: ,J (attach copy of long legal description) CONTACT INFO NATION OWNER NAME:, �/L /C�,e2 Fw I '��/� OWNER MAILING ADDRESS: STREET yZ 3 /' , -' �" C.e& �J'7elf-� J�"ri-- CITY STATE,y /' ZIP �� OWNER PHONE: 1/2S�-- 2 6 v 3----; 7-6OWNER EMAIL: P,4 tizLL /�`Q U.4( /�—�/7 9 t, were, 2 CONTRACTOR COMPANY NAME: C it;� C.e?, - 0/ 0(L''g1�� f WA STATE CONTRACTOR LICENSE#(REQUIRED): ' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: dOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: , CONTACT PHONE: 1/2 7- Z 6? - j 7b P4U rclo� /`{„� ,t CONTACT EMAIL: P/t' 1),4-CZ-/1ED /j — j7J �Fc ( � n BUILDING INFORMATION / VALUATION OF WORK:$ / 74 vl J ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor, rials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: PROPOSED USE OF BUILDING N r/"4 t /` 1'i'y � , 7 f" HEAT SOURCE: ❑Gas NElectric ❑Other BUILDING TYPE: E FR ❑Townhouse ❑lDuuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): IU ew Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot'Tub ElTank(above ground) ❑Other: DESCRIPTION OF WORK: ,.._.6 , ( i? cirs,„,„„e p2,4c, ze Y ./.7 ACKNOWLEDGEMENT:I have re we 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 I . Th 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 thoriz 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 to ontractors Law 1 .27 RCW and 296.200A WAC. �7 City of Everett Official Use Only 2 c ` PERMIT# .;0 0 Owner/Authorized Agent Signature Date (Revised 4/21/2022)