3425 COLBY AVE 2025-01-09 - Laserfiche WebLink

I ILDING PERMIT APPLICA1N CITY OF EVERETT PERMIT SERVICES EVERETT 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 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT/SITE INFORMATION PROJECT SITE ADDRESS: STREET 3L Z5 CU��(J) /�V e, PARCEL#: eV Wtif CITY WA STATE e g 2O' ZIP SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: MOW\ W, U' r lew Cor\dos C,�1corcc. O'Qo ' y' e11) OWNER MAILING ADDRESS: STREET 3`'LpA,2E Co\�0(/) Ave CITY L✓i Y/fA tAi STATE kA A ZIP cV 2_0 1 o OWNER PHONE: L�2c_Lottf.6,- I LI l7 r • OWNER EMAIL: Mt Vi 504 ® ya1�0O. COPh CONTRACTOR COMPANY NAME: �fi�l ROO f Ir1Ol Co. •WA STATE CONTRACTOR LICENSE#(REQUIRED): .STANL12 C3155T CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1 1 H CONTRACTOR ADDRESS: STREET fl l Q p y y-Eh 14vt NE CITY W uOO )Y J l l l2 STATE W A ZIP qg d•-lz CONTRACTOR PHONE: u25-yg3-CAI CONTRACTOR EMAIL: Rck\?In dayisOs+ani (oo4 nc•nefr PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 42S_ aqf 45g'1 Ralf Davis CONTACT EMAIL: g_oAita dAV►S SIV AUli1�(oCAA63•tnet BUILDING INFORMATION VALUATION OF WORK:$ 27 S) 0 0 0 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: C,OndQs PROPOSED USE OF BUILDING: HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑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: TECEEIVE1 see otifaclnecl APR 10 2024 }f CITY C• -C�E I I Rt.- I� i IT: vices ACKNOWLEDGEMENT:1 have reviewed 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.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only U1 ) Zy PERMIT# —• �i�iY1 Owner/Authorized Agent Signa re Date (Revised 4/21/2022)