2018 GRAND AVE A B 2025-09-11 - Laserfiche WebLink

.DING PERNT APPUCIO Tli- D LEC COVE p [� CITY OF EVERETT PERMIT SERVICES 1,'�,' r E R E 7 p SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requireme d nuAWofZAie2Q4ired f I view, WASHINGTON then drop off completed application plus all required submittal documents to 32�0 edar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION:(P)425.257.8810 1(E)everetteps@everettwa.gov I( VIOPIWER ETT (Blue or Black Ink Only Please) PROJECT SITE INFORMATION Permit Services i PROJECT SITE ADDRESS: STREET bIa . 14 VC--�/ PARCEL#':O ' CITY '�Le :STATE W A { ZIP ,ISU1TE/UNIT m: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): I LEGAL DESCRIPTION for new construction: Short PlaUsubdivision: Lot No.: (attach copy of long legal description) 7��7 COMTACT UNFOC�61t1ATROM i'. F-,ER NAME: 1�+ `�� OWNER MAILING ADDRESS: STREET B �j cA c et, Ave— CITY U V(—� tt— STAi�- t/V� Z[P OWNER PHONE: t 2 — � �� OWNER EMAIL: j V-J� �O f07 ®O t C® CONTRACTOR COMPANY NAME: WA STATE CONTRACTOR LICENSE-(REQUIRED): CITY OF EVERETT BUSINESS LICENSE,-(REQUIRED): �I CONTRACTOR ADDRESS: STREW tl p V CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAIVE: CONTACT EEMAIL: NE: I CONTACT I' VALUATION OF WORK: �j C—C7o ASSOCIATED LAND USE PROJECT 4(if applicable): (Valua on shall include the prevailing Lair market value or all labor,materials,and eeuipment needed to comelete the v:ork,whether actually paid or not.) t IEXISTING USE OF BUILDING: PROPOSED USE OF BUILDING: ct I, 1k 'HEAT SOURCE: as lectric Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex DU ❑Multi-Family_ . Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition KRemodel ❑Repair ❑T.I. ---]Change of Use ❑Modular ❑Portable ❑Re-roof Axterior Alteration ❑Tank(above ground) ❑Accessory Structure M ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: `DESCRIPTION OF WORK: t!h — ,Fj+IZ! , _. �O Kn» �,j�y� SIR•,--T /u7 e e" (•gyp{ et#, rC.+'C.F. f VFV I. I 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 eranting 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 properly 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 087cia/Use Oniy I PERMITA fe,� r Owncr/Authorized Agent Signa r Date (Revised 21812021)