417 TAMARACK AVE 2025-08-19 - Laserfiche WebLink

am ni BU!DING PERMIT APPLICATIOt 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)everetteps©everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 51/ 7 ^y1t�t-.-y(�Y--� pk_ 0 . PARCEL#: O 0 3 cl 3 4//t 0 p0 (n 1{60 t',r�I Crry E v . STATE Wescy , ZIP F 8 Z.C'3 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision:I,eYer 44;(Is 0,'4.(o Lot No.: (off (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: a,' 11cf. L;y. 8 rpo ivt ra_. OWNER MAILING ADDRESS: STREET L-( ( 7 -ctzmo.te-n k O r-, CIY E V tr'.e STATE Wct., ZIP '35 2.. OWNER PHONE: Li Z 5-- Zee,- L{Z 3Z OWNER EMAIL: b;Li LO---cr tjanl'� rn /;nu lC . d-a irk, CONTRACTOR COMPANY NAME: 5 ex-rYt an?e.r r�1 d'c r rca.1 C rtr--►+"�A r WA STATE CONTRACTOR LICENSE#(REQUIRED):5{E R I1�tpG'74 l CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): SS LI 3 CONTRACTOR ADDRESS: STREET �" Cm E kte t'a 11 • STATE 1,44c ZIP 9 a Z a CONTRACTOR PHONE: if Z,S= t-1 Li-p t-j g i CONTRACTOR EMAIL: $ham yyZ ,pzS p c, r 4`9 try c l,e A i,, PRIMARY CONTACT: DOWNER ,'CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Lj�S-_a Y Li_ a Y.s6 _ 1 r � P r Gt t-t lier-Y CONTACT EMAIL:$� � Prrnaal 9f �ri cpyn�;/. C°r,tvt 2.2 v BUILDING INFORMATION II VALUATION OF WORK:$ 22- / on ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market e of at labor,materials,and equipment needed to complete the work,whether actually paid or not.) • EXISTING USE OF BUILDING: -S,F R PROPOSED USE OF BUILDING: 5. F 12 HEAT SOURCE: Gas [Electric [Other BUILDING TYPE: NSFR [Townhouse [Duplex OADU ❑Mufti-Family-#Units: ❑Commercial [Accessory Structure TYPE OF PROJECT(check all that apply): CI New Construction [Addition [Remodel ❑Repair OT.I. OChan9e of Use ❑Modular [Portable ORe-roof [Exterior Alteration [Tank(above ground) [Accessory Structure [Fence over 7ft high ORackStorage OPool/Hot Tub [Tank(above ground) [Other: . DESCRIPTION OF WORK: ' e-11:i s , 61 S F(Z w°t tl b r<vrt-avre..a, ca..r1J, trkC S F R w t 11 be- bc,t('t 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.tam the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT(Revised # _� ' , 12-/3- zozz 52/8/2021) 22 l 2 - O +CO Owner/ uthorized Agent Signature Date