1823 STATE ST 2022-11-03 - Laserfiche WebLink

INN BALING PERMIT APPLICATIN 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 (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1823 State St PARCEL#: 005632-354-005-00 CITY Everett STATE WA zip 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Piatisubdivision: St.Nicholas Add Blk 354 Lot No.: 5&6 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Tracy Sublett OWNER MAILING ADDRESS: STREET 8429 14th Place SE CITY Lake Stevens STATE WA zip 98258 OWNER PHONE: OWNER EMAIL: tracybear2004@yahoo.com CONTRACTOR COMPANY NAME:LEXAR Homes WA STATE CONTRACTOR LICENSE#(REQUIRED):LEXARH*850NC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 61588 CONTRACTOR ADDRESS: sTREET3721 116th St. NE, Ste 9 curl' Marysville STATE WA ZIP 98271 CONTRACTOR PHONE:360.657.1968 CONTRACTOR EMAIL:TRhynes @lexarhomes.com PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) Agent CONTACT NAME: CONTACT PHONE:425.238.6324 Stacy Smith, S L D S CONTACT EMAIL:stacy@stacysmith.net BUILDING INFORMATION VALUATION OF WORK:$178,000 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:Project is for new construction PROPOSED USE OF BUILDING:Single Family Residence HEAT SOURCE: ❑Gas C✓]Electric ['Other BUILDING TYPE: ZSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ONew 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 DTank(above ground) ❑Other: DESCRIPTION OF WORK: Construct new single family residence on subject parcel - parcel should have obtained a demolish permit to remove the pre-existing structures. 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 l am authorized by the owner of this property to perform the work for which application is made. and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Stacy Smith - 03.26.2021 PERMIt#2 6 r I — ort_i Owner/Authorized Agent Signature Date (Revised 2/8/2021) I I Z