203 MADISON ST 2022-07-20 - Laserfiche WebLink

ism BIDING PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 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 203 MADISON AVE. PARCEL#: 00435800000100 cry EVERETT STATE WA Zip 98203 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:RYAN PIMENTEL OWNER MAILING ADDRESS: STREET 203 MADISON AVE. cliy EVERETT STATE WA zIP 98203 OWNER PHONE:425-344-8742 OWNER EMAIL: ryanrpimentel@hotmail.com CONTRACTOR COMPANY NAME:Construction Assests LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):CONSTAL864BL CITY OF EVERETT BUSINESS LICENSE#(REQUIRE ): CONTRACTOR ADDRESS: STREET 6105 190TH ST SW CITY LYNNWOOD STATE WA zip 98036 CONTRACTOR PHONE:425-244-0133 CONTRACTOR EMAIL:cassets@yahoo.com PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR 0 OTHER(Please Specify) ARCHITECT CONTACT NAME: CONTACT PHONE:425-317-8017 SAN D RA H I G G I N S CONTACT EMAIL:sandra@caparchgroup.com BUILDING INFORMATION VALUATION OF W RK: $45,000 ` ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair mark gk value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF ILDING9fImary Residence PROPOSED USE OF BUILDING:Primary Residence HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: ❑r 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: New addition area of 358 sq. ft. that consists of new bedroom, a full bathroom and a laundry room. 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. /Xt City of Everett Official Use Only j?/A/ PERMIT# 6/18/2021 2`0 6, 04(4 Owner/Authorized Agent Signature Date (Revise 2/8/2021)