2225 103RD ST SW 2022-05-02 - Laserfiche WebLink

BIDING 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 2225 103rd St SW PARCEL#: 00538200005902 cry Everett STATE WA ZIP 98204 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Paine Filed 5 BLK 000 D-02 S 125 Ft of Lot No.:59 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Sonja Widgahl OWNER MAILING ADDRESS: STREET 15325 22nd PI W SIT, Lynnwood STATE WA ZIP 98087 OWNER PHONE: (425) 330-9503 OWNER EMAIL: CONTRACTOR COMPANY NAME:Robbins and Co. WA STATE CONTRACTOR LICENSE#(REQUIRED):ROBBICH 169NQ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 55630 CONTRACTOR ADDRESS: sTREET818 SW 142nd St crTy Burien STATE WA ZIP 98166 CONTRACTOR PHONE: (206) 244-1023 CONTRACTOR EMAIL:charlene@robbinsandco.com PRIMARY CONTACT: 0 OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(206) 244-1023 Charlene Martinez CONTACT EMAIL:charlene@robbinsandco.com BUILDING INFORMATION VALUATION OF WORK: $19,422 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: Single Family Residence PROPOSED USE OF BUILDING: Single Family Residence HEAT SOURCE: LIGas (]Electric ❑Other BUILDING TYPE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ORepair ❑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:Repair existing foundation of existing single family residence by installing 3" push piers per the engineered plans. 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.1 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 1 .27 RCW and 296.200A WAC. �/j City of Everett Official Use Only A.°'(//14( G J !� PERM16 2Z b O Ow er/Authorized Age t S' ature D to/z (Revised 2/8/2021)