921 105TH PL SE 2022-10-14 - Laserfiche WebLink

. 1111111111 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 921 105th PI SE PARCEL#: 00697000003800 or( Everett STATE WA ZIP 98208 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:Arthur Young OWNER MAILING ADDRESS: STREET 921 105th PI SE cITY Everett STATE WA zip 98208 OWNER PHONE:206-305-1634 OWNER EMAIL: arthurbyoung@gmail.com CONTRACTOR COMPANY NAME:Town & Country A Division of Permabilt WA STATE CONTRACTOR LICENSE#(REQUIRED):TOWNCPF0a9LT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 12646 CONTRACTOR ADDRESS: STREET 16521 Highway 99, Suite C CITY Lynnwood STATE WA ZIP 98037 CONTRACTOR PHONE:425-743-1555 CONTRACTOR EMAIL:permitdept@permabilt.com PRIMARY CONTACT: ❑OWNER D CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-743-1555 Permit Department CONTACT EMAIL:permitdept@permabilt.com BUILDING INFORMATION VALUATION OF WORK:$33,206 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:House PROPOSED USE OF BUILDING:Garage, 21'x21'pole building, no heat or plumbing HEAT SOURCE: ❑Gas DElectric DOther N/A BUILDING TYPE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: DCommercial DAccessory Structure TYPE OF PROJECT(check all that apply): DNew Construction ❑Addition ❑Remodel DRepair DT.I. ❑Change of Use DModular DPortable ❑Re-roof DExterior Alteration ❑Tank(above ground) DAccessory Structure ❑Fence over 7ft high DRackStorage OPool/Hot Tub OTank(above ground) DOther: DESCRIPTION OF WORK: 21'x21' pole building, no heat or plumbing ACKNOWLEDGEMENT:1 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.l 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 PERMIT# Permit Department M.,�� •- 11/30/21 2 Z 0 0 5 I Owner/Authorized Agent Signature Date (Revised 2/8/2021)