5300 GLENWOOD AVE 2016-10-03 - Laserfiche WebLink

� PERMIT APPLICATION BUILDING�'IVIECHANICAL / PLUMBING / SIGN / INKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.govlpermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: j?jbd �l.!-�IJW�� /a� ��/~2- PROPERTY TAX #: �43�a�ogaoZca LEGAL for new construction: Short PlaUsubdivision �� L�fl.� Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: )'V( 1 U'�� E� �/✓�l7�K TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTReeT S�o 4�� %�VF� � N"2- CITY �jUY/"ri� STATE �✓'A ZIP �O �ib3 OWNER PHONE: �IK-�-3$" (o`JY? OWNER EMAIL: CONTRACTOR NAME: 1,dNd+4�lL� �iN �`N✓I�S CONTRACTOR ADDRESS: sTReer r O �-Z� �'l'� 1N ST CITY �� STATE w� ZIP !�� ° 1 CONTRACTOR PHONE: �1S " �l �' Cj�p(po CONTRACTOR EMAIL: SuN�AI�/LE-f'c�tJ 3. P�/�t�Swl.t.� CONTRACTOR LICENSE #(REQUIRED): SNN�A�Safo3�`I CITY OF EVERETT BUSINESS LICENSE #(REQUI : 32�SZ- PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: e�� y� CONTACT PHONE: �25��/�`IGLo /J / IGES N/J.,9/�/GG Ea✓lLl� S�i CONTACT EMAIL: �1//I/LWN�/✓�,j'Z(�M•�/`�•�/�'�- BUILDING PERMIT APPLICATION Existing Use of Building: sy�l�-- L�ND�O Contract Price of Work: $'�S"2-S •�' Proposed Use of Building: j�l� �N�o Heat Source: �as ❑Electric ❑Other Buildin T pe: ❑SFR-Detached ❑SFR-Attached ❑Duplex ulti-Family-# of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ��AG/N� �CST.cIG. L¢�i'S FdiL.V�c� ASSOCIATED BUILDING PERMIT # if a licable : ACKNOWLEDGEMENT: 1 have revfewed 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. 1 am the owner, or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with th/� State Contractors Law 18.27 RCW and 296.200A WAC. �-2.rB— d [o Date City of Everett Official Use Only PERMIT # � � �� p � I� (Revised 5/20/2016) �S , ��