2730 PINE ST 2021-12-10 - Laserfiche WebLink

• • Imo az 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 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2730 X Pine PARCEL#: 00593663602100 CITY Everett STATE wa ZIP 98201 SUITE/UNIT#: FLOOR#: 2 / 3 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:Dorian Serna OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE:206-351-9102 OWNER EMAIL: CONTRACTOR COMPANY NAME:KLR Custom Designs WA STATE CONTRACTOR LICENSE#(REQUIRED):KLRCUCD843DJ CITY OF EVERETT BUSINESS LICEN #(REQUIRED): (330 7 CONTRACTOR ADDRESS: 5TREET4815 224th st sw CITY mountlake terrace STATE wa ZIP 98043 CONTRACTOR PHONE:425-563-9364 CONTRACTOR EMAIL:klrcustomdesigns@gm- .- PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-563-9364 Kyle Renfrow CONTACT EMAIL:klrcustomdesigns@gmail.com BUILDING INFORMATION VALUATION OF WORK:$1500 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:4 Ultf-fat tly=dweliIng A'1\ \ (\vJe'�`;‘(\ PROPOSED USE OF BUILDING:multi:fatm'lily-dwelling "S- k_AA &JAVif HEAT SOURCE: ❑✓Gas ❑✓Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex EADU ❑✓Multi-Family-#Units: 3 ❑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 ElPool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:Repairing damage done from water intrustion -replacing exterior door where water was leaking from under threshold -replacing 4'x4' square of subfloor -replacing 4'x4' square of drywall -replacing exterior door -cauking and seal all new work ACKNOWLEDGEMENT:I 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 ` 4/6/2021 PERMIT 2 l 1 _ oil H Owner/Authotized Age t Signatul Date (Revised 2/8/2021)