2502 E GRAND AVE 2025-09-30 - Laserfiche WebLink

i JILDING PERMIT APPLICA. _JN 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 1(E)everetteps@everettwa.gov (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 25D7 514-37 61 A,1,0 /IvEr iu� PARCEL#: Oo 5 to8 582 o I-100 CITY ��cQ r STATE WA zlP 982o I SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION!INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: I I cp, (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: IJ u ot� I Iot11S I�F I l " FA 0LA OWNER MAILING ADDRESS: STREET Z5o2. CgSr (aeq.1fl CITY EQE.,e�� STATE WA, zip 982p OWNER PHONE: (55�r to J 8 - 2S OWNER EMAIL: cJ' � Mc�• C o N1 CONTRACTOR COMPANY NAME: Cm,-rnt.c,h Cy-) WA STATE CONTRACTOR LICENSE#(REQUIRED): I R S013H CITY OF EVERETT BUSINESS LICENSE*(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR OTHE R(Please Specify) f�I�r�T�-f CAS L)K,grTn1L, CONTACT NAME: CONTACT PHONE: tt (2r�) Z25 - 8 �nu�.t�4S i+LMor(o CONTACT EMAIL: o�c o�C' rlco.�. co.-✓� BUILDING INFORMATION VALUATION OF WORK:$ 15 00� oo 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: I L.L.E PROPOSED USE OF BUILDING: f to c A L. L,r=_ HEAT SOURCE: ❑Gas ®Electric ❑Other BUILDING TYPE: IISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial []Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel XRepair ❑T.I. ❑Change of Use []Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: � WA,EZ b4MA-L-0 --7 TLa Amy}C-1 i;t— a `s 7 p ECEOVC NOV 0 6 2023 ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant(9 i t current federal,state,#no local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first PIA A�ht'�bfi'it ��a Building clal before being out 'nzed,under any circumstance.I am the owner,or l am authorized by the owner of this property to perform the work for which application is made, and 1 omp with ih 'State Co tractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# �� 2 o z� 1� (J Owner/ t ize 'Agent Signature Date (Revised 21812021) i