3200 CEDAR ST PANAMA BLDG 2025-09-10

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES l��;J F EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and nu er f copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar$trei t 2ndtjoor lgta, a Drop Box. CONTACT INFORMATION:(P)425-257-8810 (E)PermitServices@everettwa.gov, (W)ev �e)t�va.goyt%p r'mj-s 2023 1 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET �ZOO C69 A/L ST' PARCEL M OD g MM CITY � STATE ZIP SUITE/UNIT M FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): �`j Ty 6F Ft/Z;;�►/2F/�— R- (t I r) LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT (INFORMATION n �ff /� OWNER NAME: � % r ��2C/T r�/iL jL1 // L5 `-460` CaS� /�HC/SQ)'J OWNER MAILING ADDRESS: STREET 6C-4 411c, CITY �^ �? STATE / ZIP 9 Q OWNER PHONE: -S� OWNER EMAIL: 7LCS /v C —IT 4,6 D CONTRACTOR COMPANY NAME: Ci G WA STATE CONTRACTOR LICENSE#(REQUIRED): Hj IDS t(0.2.O.D CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (P70 53 CONTRACTOR ADDRESS: STREET CRY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: WNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: / CONTACT PHONE: -elz 'JS —S Q �2 �70 CONTACT EMAIL: BUILDING INFORMATION VALUATION OF WORK:$ Y v 000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: / (�fL PROPOSED USE OF BUILDING: HEAT SOURCE: []Gas ❑Electric J00ther /,1(') Zl&ef-T BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: C mmercial ❑Accessary Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portablete-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: b� /nem h,� e d,9 to"o "a l/`1��//�rUo- f��7 ACKNOWLEDGEMENT.,1 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Own uthorized Agent Signature Date (Revised 4/2 /2022)