9536 HOLLY DR 2025-07-10 - Laserfiche WebLink

BUILDING PERMIT APPLICATivN 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue of Bleck ink Only Please) PROJECT BITE INFORMATION PROJECT SITE ADDRESS: STREET �'5 3‘ P/(, PARCEL#: 00378.7 00' 00 CITY �e!% ��? STATE (,e/j ZIP j6v2 rJ L/ SUITE/UNIT It: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): / 1//X—/Q TENANT/BUSINESS NAME(if non-residential): r LEGAL DESCRIPTION for new construction: Short Plat/subdivislon: P�eLZ s p Lot No.: y (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 6O 77 I C J S bM C 0/05/nuC77ON /A" C- OWNER MAILING ADDRESS: STREET U• A DX /2 4'3 � CITY /1/K.-ys1//JL L STATE L��/j/ ZIP 5;c9 Q -ry7 / 0 OWNER PHONE: ‘72 3----8 7 6 $S/ OWNER EMAIL: ,* C(J> (0/J,$7)2ly;1 W CONTRACTOR COMPANY NAME: g j!'¢iZt\ c. WA STATE CONTRACTOR LICENSE#(REQUIRED):g'�"}CST S-76 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):5 3 3 j-f, CONTRACTOR ADDRESS: STREET 0. t'' /1. �2 L/3 CITY 1IgAys l STATE t--(2/1- ZIP „ 76) CONTRACTOR PHONE: L/t�(- '77 —6 S S! CONTRACTOR EMAIL:,g,i),5�/p(x'cls76/761t✓jU5/gue. OA)e /fnL cutve PRIMARY CONTACT: ❑OWNER 'CONTRACTOR 0 OTHER(Please Specify) c^ CONTACT NAME:p /� /�I� CONTACT PHONE: 4), 6976-1J S \� / /, �/T uL �U S /�l CONTACT EMAI L:RL lT,/2 COntelr'0,05Y7L�1VO, /�rriJ'Lu/y BUILDING INFORMATION VALUATION OF WORK:$ 3-7 S L QQ4 ASSOCIATED LAND USE PROJECT#(if applicable): (T/aivation shall Include the prevalllng''a markdlvalue of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: /�) - I//le(yl,e/T PROPOSED USE OF BUILDING: F� HEAT SOURCE: japes ❑Electric ❑Other BUILDING TYPE:S5FR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): Alew Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ORe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure OFence over 7ft high ❑RackStorage ❑Pool/Hot Tub OTank(above ground) ❑Other: DESCRIPTION OF WORK: _ (c4 s7/Lu c7 �(/cc,t� / 72 D OCT 2 7 2023 .J i fTY OF EVERETT ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done men i�r?l11i y with current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must r n w ng 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 Contr.otwa Lew 10.27 RCW and 206.200A WAG. City of Everett Official Use Only / C 7_ ` PERMIT# Owner/Autho zed Ag6rtivi at Date (Revised 4/21/2022)