1425 MADRONA AVE 2017-01-13 - Laserfiche WebLink

F��F�Nili �.F'P�IC,�►T'IO BUILDIiV�111ECF-I�,NIGP,L. I PLlJi�1E31NG I SIG F21NKL�R /�Ef1��LITIOiV CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@evereffinra.gov � www.everettwa.gov/permits , , , ` _ _ ,- PROJECT SITIE IiV�OiiM�►TION :: ; - __ . : _ .. _. __. ,: _. _ _ PRO,l��T �ITE ADDRESS: PROPERTY TAX #: �� ' P L�; �(� S l U( `-t �.�j j+�,� ' �c: ,�-'� '� _ LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of long legal description) _. _ -' CONTACT INFORMATION _ OWNER NAME: �� L�}f�� L I<--vL-� l'�. TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTHeEr y Z� ! 1'�A �r� J�.1.� ��e£ CITY �-�1i,�� T�I— STATE L.L. �%� ZI P / l3 �—C✓ �� OWNER PHONE: �(.'lc: vl��,; 1 Ly,�; OWNER EMAIL: ,....-. .., . . : . _ . .... .. : .: . .. . . .. ... � . . . . . .. . CONTRACTOR NAME; C�v�%1. r�� LL 5 �Lu ��. /j t�'� � �/� Z. , CONTRACTOR ADDRESS: sTREET � L- L�u � `� �� I I � � � )� CITY G�-�— �, STATE �J�� "a' ZIP �_ U LL%�C.% t�. �: ('�j. CONTRACTOR PHONE: Z. �'" Z�4 -��l% t� CONTRACTOR EMAIL: �� s. �'�t c`�` C'�=�.�- ��K � S- ✓� iv,.y;��j I'v� � C G c-��t CONTRACTOR LICENSE #(REQUIRED): C t� �"'� I�'� �S i�� - �-t l� �"�'1 �j CITY OF EVERETT BUS(NESS LICENSE #(REQUIRED): �� t � PRIMARY CONTACT: ❑ OWNER Y ONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: � �._, �; CONTACT PHONE: �,.{ Z_S Z�j� ` 3� i1� L.� _� 1'e 6-� � CONTACT EMAIL• S.� �` .� �., [��.� J4y� l� 5 '11ti,�.--� Li,.-: , C c�-�� ` ' ` ` BUILDING PERMIT APP.LICATION _: .; Exisfing Use of Building: i�-`=": L"" ti'��' `�- � Contract Price of Work: $ �''� r��', Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached C�FR-Attached ❑Duplex ❑Multi-Family�# of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK _ - i �r . ,� �..�_ �t� ;c�: - —`� c _ ' �, -�+��, �'�.) � a. c-.''_ _ - �ASSOCIATED BUILDING PERMIT # (if applicable): � ACKNOWLED6EMENT.' 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant fo this perrnit musf comply with cur�ent federal, stafe, and local law. Tl�e .qranting of a permrt only authorizes approved work and no devrafions theref�om. Deviations musf firsf be auihonzed in writing from the Building Official before being au nzed under any circumstance. I am the owner, or! am authonzed by the owner of this property fo perform the work for whfch application is made, and / comply with the Sfate Con actors 8.27 fZCW and 296200A WAC. � Cify of Everett Official Use Only PERMIT # J L l� j � O Owner/Aufhori gen �ignature ate (Revised 90/92/2015)