4715 FOWLER AVE 2025-09-11 - Laserfiche WebLink

BUILDING PERMIT APPLICATION 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 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 7 l e/ PARCEL#: /) CITY E t 1r t STATE ZIP SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): p,I-IF LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Rt M a I " Lot No.: (attach copy of long legal desc(ption) y1 c CONTACT INFORMATION OWNER NAME: �L� Ktr-- OWNER MAILING ADDRESS: STREET 14715 f ovk Avc CITY t rC STATE WA ZIP 8 LIJ� OWNER PHONE: 6 OWNER EMAIL: L j1-n CONTRACTOR COMPANY NAME: SO]u--i 0 A JIL WA STATE CONTRACTOR LICENSE#(REQUIRED) F EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 82 1-7 171 t Ave- 1 CITY `4 df eA STATE NA ZIP 2 CONTRACTOR PHONE: L125— 23--j I CONTRACTOR EMAIL: � cT��Q �,�/ f c�T ,f o�v�;on tarn PRIMARY CONTACT: KOWNER ❑CONTRACTOR ❑OTHER(Please Specify) r� .-S t t ti CONTACT NAME: •T CONTACT PHONE: Lf.-S- 9,51, 2 l CONTACT EMAIL: �t� r��_. C ! vt,C OM B LDING INFORMATION VALUATION OF WO K-$ 0 .Q D ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the pr ailing fair Market value of aU labor,materials,a equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDI i PROPOSED USE OF BUILDING: = h1 1 y HEAT SOURCE: []Gas ,(Electric C7Other BUILDING TYPE: ❑SFR []Townhouse ❑Duplex ❑ADU Multi-Family-#Units: []Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): El New Construction ❑Addition XRemodel ❑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: �ns iid� Ins �>) On Qh tfWGW d"a pt iG6 56C.-throcK ��s�"�Ilc c� in �.�+:�e h okse. on well,$$ wnJ /C..-I c. g&Lh jA!e'1- -�It ZX7.f L�datd TIt fJNSh CM+ Ylut 111/I CI Ptr�� -� Set �JJ [ [ a�� D SEP 0 3 2023 ACKNOWLEDGEMENT 1 have reviewed this application and confirm the information contained herein is true and correct.Work dQ^� a �h' ��I with current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviatiol;> st irs Q aa�i 3n'wrltingYrom the Building Official before being authorized under any circumstance./am the owner,or 1 am authorized by the owner of this property to ppr di RL�ItIY Br(tM196$lication is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only ho PERMIT# ) �O 'Ol Owner/Aulbrized Agent Signature 'Date (Revised 412112022)