9538 HOLLY DR 2025-07-10 - Laserfiche WebLink

• INN ion BUILDING PERMIT APPLICATR.PN 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)PerrnitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET /S 3 9 �p1 L Y p/?, PARCEL#: 003769 00 X 00600 STATE (..-10 ZIP CA '2 617 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): /2Pi/,j—/Q TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Pl�i�CZ S p Lot No.: S— (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 6o C J s7 oM ,C CU/tJ✓1 ucj/c)N /i4/ C- OWNER MAILING ADDRESS: STREET " (.)• A OX /, 4,3 CITY Mrlk—YS1//L,/ L_ STATE (...L/1/ ZIP 5?c 7 0 OWNER PHONE: ‘72 S (i 7 6 -6 . S/ OWNER EMAIL: j' �,� (t7/0 j�1„r;l/C>�0 ��/,/ l CONTRACTOR COMPANY NAME: C o 70i ( `4 /WA STATE CONTRACTOR LICENSE#(REQUIRED):Pax 1) .EA-if; CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):5 3 j 3-6 j CONTRACTOR ADDRESS: STREET 1 O. 67Cafi. /?, '3 CITY /-1/Q/1S/211 l STATE C��` ZIP CONTRACTOR PHONE: L/ ( }A--E,S S I CONTRACTOR EMAIL:4g,i) 60,12.5-j'guc 0Aitx/JAL Cc ice( PRIMARY CONTACT: ❑OWNER agONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: j-te) _ 97 �J ,9UL ftS`i /Z CONTACT EMAIL:AL/&2,6CU�117,-/ oALc- 7l l7oA.)as,f�7/1�1�c)/Y BUILDING INFORMATION VALUATION OF WORK:$ "3 g l O ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevalling-t k market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: /0/1- 1/71(6e7e/7 /C> PROPOSED USE OF BUILDING: S� HEAT SOURCE: Alias DElectric ❑Other BUILDING TYPE:f?d$FR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial DAccessory Structure TYPE OF PROJECT(check all that apply): pirtaew Construction DAddition DRemodel DRepair ❑T.t. ❑Change of Use ❑Modular ❑Portable ORe-roof ❑Exterior Alteration DTank(above ground) DAccessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: ((D ST IL() O C T 2 7 2023 CITY OF EVERETT Permit Services 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, a..d/ccwrrply with tho Stott,Contraotcra Law 113.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent5Tgagv,/ t a Date (Revised 4/21/2022)