1001 39TH ST 2016-01-01 MF Import

' �.J. • ��dTY OF E vERET7' �r�`��,,�,,�•. � P.LANNING AND COMMUNITY DEVELOPt�1ENT '�,�`�;,� � LAND (ISEPERMITAPPLICATION '"` "� ❑ Boundary Line AdjusUnent ❑ Lot Ccrtification FOR OFFICE USE ONLY ❑ Nonconforming Use/Building �2 Q/ l8[ Planning Director Dc[ertnination�.r f7LE a � � ��¢ ❑ Planning Director Detertnination� �r ❑ Planning Director Detertnina;ien� FEE S �� J RECEIPT�t ��c39� � P�ezone � ❑ SEPA I UJ l5 � LS O V l5 � ❑ Shoreline ' Rl ❑ Short Subdivision U u q p R � 9 1 9 9 6 ❑ Special Property Use I19 ❑ Special Property Use IIIB � Subdivision CITY OF EVERrTT ❑ Variance � • ❑ Other Applicant�c,/'��.-.�li�S<SD/J Phone �r'/1�—//6� Address S80 - G GrG l.Y/ B O Fax Property Owner_ �S Q/jT Phone Address Primary Contact (�eoma u�eppli�c� Phone Address gyX Property Address or Location 4�D�O x/nrlo fc�v /D��' 3 91�St/`U erc- �t Tax Identification Num�er �/7D? -D D� -0�S-p oo S LegalDeseription(e�cachifnec�ssary)�cf �S;31> aCoc.�,�% /,i�w;l'{ �e��,hfs Zoning,�-l Sin9/B Gu m�i�v�Comprehensive Plan Designat:on Area of Property�ncre�sq�,ar�FKe� /�// `•� S 3 x /�lS�/!J Q fj o� � / � � Project Description List the name of the planner you have discussed your proposal with I am the owner or am authorized by the owner to sign and submit this application. I grant pertnission for City staff and agents to enter onto the subject property for the sole purpose of making any inspection of the property which is necessary to process this apnlication. [certify under penalty of pequry of the laws of the State of Washington that the infortnation on this application and all infortnation submitted herewith is true, complete, and cortect and hereby agree to defend, pay, and save harmless the City of Everett, its officers, employees, and agents from any and all claims, including cosu, expenses and attomey's fees incurred in investigation and defense of said claims whether real or othenvise which may be hereafter made by any person including the undersigned, his successors, usigns, employees, and agents, arising out of reliance by the City of Everett, its officers, employees, and agents upon any maps, designs, drawings, plans or specificati�ns, infomiation or any statements, including the reasonable inferences to be d�awn therefrom contained in the application or submitted along with said application. �'-�9 Signature by Owner/ApplicandAgent (O�Y) Date�--C/6 City and State where this application is signed �,o.e�,�� CL�Sh 98�-D� Ciry State � 2930 Wetmore, Ste 100, Everett, WA 98201 '�' (206)259-8731, Fai (206)259-8742 � ��7