11305 W IBBERSON DR 2026-04-09 - Laserfiche WebLink

BUILDING PERMIT APPLICATI JUN 2 6 2025 EVERETT CITY OF EVERETT PERMIT SERVICES D SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requireme is and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents t�8�1�0Y�d Fs&V&R oTrTntake Drop Box. CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gop0mitrelT-0ylWits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET OS ARCEL M 000 CITY �' STATE ZI SUITE/UNIT M FLOOR M ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): l LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: — OWNER E ' CONTRACTO CO NAME: / 6� ✓�-11�� l /�!-s WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE##(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT. WNER [ICON TRACTOR ❑OTHER(Please Specity) j CONTACT NAME: CONTACT PHONE: 10I CONTACT EMAIL: BUILDING INFORMATION VALUATION OF WORK:$ AS LAND USE PRO R T#(if applicable): (Valuation shall Include the prevailing fair market value of all labor,materials,and equipment needed to complete the vrork,whether actu or not. EXISTING USE OF BUILDING: PROPOSED USE OF BUILDING: l J / HEAT SOURCE: ❑Gas Nectric ❑Other BUILDING TYPE: R ❑Townhouse ❑Duplex ❑ADU []Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition []Remodel p it ❑T.I. []Change of Use ❑Modular ❑Portable ❑Re-roof El Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub []Tank(above ground) ❑Other: DESCRIPTION OF WORK: ".,�,)/�� --2� �G•��E��t �'G�c�f�i�l � o�17r"eQs� � /"e'C// ACKNO66 EMENT:!have reviewed this application and confirm the information contained herein is true and correct.Wo 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. viations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the o am authorized by the owner of this property to perform the work for which application Is made, and(lcomply with a State Contractors Law 18.27 RCW and 296.200A W l City of Everett Official Use Only PERMIT# r 5c) Owner/Authorized Agent Signature a (Revised 412112022)