6912 E CADY RD 2023-10-24 - Laserfiche WebLink

• II/ E 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 6912 East Cady Road PARCEL#: 00393300005300 cry 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: Beverly HMS Div s BLK 000 D-00 Lot No.:53 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Barry&Darlene Stroyan OWNER MAILING ADDRESS: STREET 6912 East Cady Road cm, Everett STATE WA zip 98023 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:Uniplex Construction LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):U N I PLCL876L6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED); 53989 CONTRACTOR ADDRESS: STREET14737 - NE 87th ST. cITY Redmond STATE WA ZIP 98052 _ CONTRACTOR PHONE:206-858-2259 CONTRACTOR EMAIL:robert@uniplexconstruction.com , PRIMARY CONTACT: ❑OWNER ✓C7. CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-858-2259 Robert Meyers CONTACT EMAIL:robert@uniplexconstruction.corn BUILDING INFORMATION VALUATION OF WORK:$85000.00 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevalling fair market value of at labor,materials,and equ pment needed to complete the work,whether actually paid or not) EXISTING USE OF BUILDING:Existing home PROPOSED USE OF BUILDING:Same HEAT SOURCE: ❑Gas ['Electric DOther BUILDING TYPE: ❑✓SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: El 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:Repairs to roof structure damaged by tree strike ACKNOWLE GEMENT::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 fed}tral, tate,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 h the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only � � f 11/16/2022 . PERMIT#.F,49101 I i `-' orizi Own` u ized. .t,/ ge nt I nature Date (Revised 4/21/2022) 1/z