7623 TYEE RD 2025-10-24 - Laserfiche WebLink

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES E V E R E T T 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 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits (Blue or Black lnk Only Please) ' '' : PROJECT SITE,I,NFORMATION,_ .' _y. _ . • PROJECT SITE ADDRESS: STREET 7(p2.� jPARCEL #: 0�2(p CITY L. STATEWA ZIP 3 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: M +�� OWNER MAILING ADDRESS: STREET -3pa �i5 l�Q,IVE �E CITY E �71WF'15- STATE OWNER PHONE: 2. OWNER EMAIL: CONTRACTOR COMPANY NAME: 21f I Ol uLA� _Ir J h G WA STATE CONTRACTOR LICENSE #(REQUIRED),,:H G RIT 131939 SL IciTy of VERETT BUSINESS LICENSE #(REQUIRED): lD c33 S r IF CONTRACTOR ADDRESS: STREET �j QD �/p�J��'�� CITY L a ke, & �/Y STATE /'1 J ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: .......... ,, .........._..._. _ _ . _.._.-,......, _.._...__.......... ._... _ .... _._.. ...-..,.. PRIMARY CONTACT: X OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CO TACT NAME: CONTACT PHONE:-��—: g� CONTACT EMAIL: i 4 i� _t9 w ss a a e- ®C[r P, ; C BUILDING' INFORMATIQN VALUATION OF WORK: $ ,�?. oQ 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: <_'nc i 1 PROPOSED USE OF BUILDING: 5 IN ,{1 I i� A HEAT SOURCE: []Gas RElectric Other BUILDING TYPE: J'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 El Exterior Alteration ❑Tank (above ground) ❑Accessory Structure []Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub []Tank (above ground) 90ther: r 4% Ca1� !e SJl`i DESCRIPTION OF WORK: `^ Cb ti�� C K 1.11 10 c �%� Is � I d� l a u acl rJcf_lec-4-r ' J j , d, j L ca t> 0 P C1 CLI-�- r��41 nj '� -cel. �rn�c VJ shy' r arr I ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correct. Work done r ant to per it must comply with current federal, state, and local law. The grantin of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the Building Official before being authorize der ny circumstance. / am the owner, or I am authorized by the owner of this property to perforlrffyrl01Fwh sE1i f t oonTTade, and I comply with the State Contra r La 18.27 RC W and 296.200A WAC. l� E I ► ret�tfm}} &�++ rrs`eoGtt'l�a�� ice S City of Eve�'dJ PERMIT # 3 l 0� Own erfAutlTonz'eWggtyCSignature Date (Revised 412112022)