4953 ELM ST B 2025-01-06 - Laserfiche WebLink

MIMI 0 • n. BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASH/N(3,0N 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 4953 Elm Street PARCEL#: 006063-000-021-00 cm 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: View Ridge Add Div 3 Lot No.: 21 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Marcos &Silvia Santana OWNER MAILING ADDRESS: STREET 4953 Elm Street co-y Everett STATE WA Zip 98203 OWNER PHONE:425.770.5387 OWNER EMAIL: marcossan1974@gmail.com CONTRACTOR COMPANY NAME: M/AZ,_,) WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR Z OTHER(Please Specify) Agent for Applicant/Owner CONTACT NAME: CONTACT PHONE:425.238.6324 Stacy Smith, Smith Land Development CONTACT EMAIL:stacy@stacysmith.net BUILDING INFORMATION VALUATION OF WOR $150,000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the pre fling fair marke value of all labor,materials.and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUIL I • PROPOSED USE OF BUILDING:single family residence HEAT SOURCE: HGas ❑✓Electric Other BUILDING TYPE: ❑✓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 LIRe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high 11RackStorage I (Pool/Hot Tub FITank(above ground) ❑Other: DESCRIPTION OF WORK: Construction of new 1100 sf single family residence. Existing 736 sf residence to be converted to ADU 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 PERMIT# Stacy Smith 07/08/2021 5 v 1 0 1 - 6 4 Owner/Authorized Agent Signature Date (Revised 2/8/2021) 1 '\ zJ