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6611 WETMORE AVE 2022-07-28
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6611 WETMORE AVE 2022-07-28
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Last modified
7/28/2022 1:26:30 PM
Creation date
7/28/2022 8:35:25 AM
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Address Document
Street Name
WETMORE AVE
Street Number
6611
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BUILOG PERMIT APPLICATION • <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425.257.8810 l(E)everetteps@everettwa.gov l(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 6611 Wetmore Ave PARCEL#: 00544700301700 <br /> cm(Everett STATE Washington zip 98203 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Andrey Kamenchuk <br /> OWNER MAILING ADDRESS: STREET 6611 Wetmore Ave <br /> c,T„ Everett STATE Washington ZIP 98203 <br /> OWNER PHONE:4252998362 OWNER EMAIL: rock.chuk@gmail.com <br /> CONTRACTOR COMPANY NAME: Andrey Kamenchuk <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4252998362 <br /> Andrey Kamenchuk CONTACT EMAIL: rock.chuk@gmail.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$ 12,300 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of an labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING: <br /> PROPOSED USE OF BUILDING: <br /> HEAT SOURCE: ✓❑Gas DElectric ❑Other <br /> BUILDING TYPE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ✓❑Remodel ❑Repair ❑T.1. ❑Change of Use <br /> [Nodular ❑Portable ORe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other <br /> DESCRIPTION OF WORK: Finishing daylight basement. <br /> J <br /> JUL 13 2021 to <br /> CITY OF EVERETT <br /> Permit Services <br /> 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 <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT#7/9/21 B2106-010 <br /> Owner/A gent Signature Date (Revised 2/82021) <br /> ,/Z <br />
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