800 GRAND AVE 2022-11-17 - Laserfiche WebLink

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) PermitServices@everettwa.gov i (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 800 Grand Ave PARCEL#: 29051800101300 cny Everett WA STATE zip 98201 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:Michael Zyskowski & Gina Jamison OWNER MAILING ADDRESS: STREET 800 Grand Ave clry Everett STATE WA ZIP 98201 OWNER PHONE:425-879-2430 OWNER EMAIL: zyskowski@yahoo.com CONTRACTOR COMPANY NAME:New Vision Construction WA STATE CONTRACTOR LICENSE#(REQUIRED):NEWVIVC91 1 BL CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 64299 CONTRACTOR ADDRESS: STREET P.O. Box 806 ciTy Monroe STATE WA ZIP 98272 CONTRACTOR PHONE: (425) 361-5661 CONTRACTOR EMAIL:newyisionfierke@ gmail.com PRIMARY CONTACT: EI OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-879-2430 Gina Jamison CONTACT EMAIL:gina@academicentertainment.com BUILDING INFORMATION VALUATION OF WORK,: $20000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the preailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Residential PROPOSED USE OF BUILDING:Residential HEAT SOURCE: ❑✓Gas ❑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 ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Replace flat roof with deck. 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 Digitally signed by Michael >s IT# �` _ Michael Zyskowski Zyskowski P\ )-�35 �_ Date:2022.05.03 09:53:16-07'00' j Owner/Authorized Agent Signature Date (Revised 4/21/2022) r_,