11201 3RD AVE SE 2023-04-07 - Laserfiche WebLink

• • 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)everetteps@everettwa.gov I(W)everettwa:gov/permits (Blue or Black Ink Only Please). PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 11201 3rd Ave SE PARCEL#: 00718 900 500 800 cry Everett STATE Wa ZIP 98208 SUITE/UNIT#: 5H FLOOR#:2 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Karon Henke LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Karon Henke OWNER MAILING ADDRESS: STREET 1329 No 183rd St ctrr Shoreline STATE Wa ZIP 98133 OWNER PHONE:(206) 947-8744 OWNER EMAIL: karonhanke@gmail.com CONTRACTOR COMPANY NAME:EWing General Contractors LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):EWINGGC827QI CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 63955 CONTRACTOR ADDRESS: STREET 1 14 NW 1 81 st St cry Shoreline STATE Wa ZIP 98177 CONTRACTOR PHONE:(206) 930-1702 CONTRACTOR EMAIL:bruceewinginc@msn.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(206) 930-1702 Bruce Ewing CONTACT EMAIL:bruceewinginc@msn.com BUILDING INFORMATION VALUATION OF WORK:$25,000 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:MUlti-family Condo PROPOSED USE OF BUILDING:Same HEAT SOURCE: EGas ❑✓Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ✓❑Multi-Family-#Units:6 ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction EAddition ❑Remodel l 1Repair ET.I. EChange of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) EAccessory Structure ❑Fence over 7ft high ❑RackStorage EPool/Hot Tub ETank(above ground) ❑Other: DESCRIPTION OF WORK:Remove/replace , plumbing, electrical fixtures(No structural changes, no sq' added. /'v —..— 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 b or b ing authorized under any circumstance.lam the owner,or/am authorized by the owner of this property to perform the work for which application Is made, and I comply with e t e Contractors Law f 8.27 RCW and 206.200A WAD. if City of Everett Official Use Only { - PTm2i k 7 -- ©2C� Owner/Auth ze Agent Signature D to (Revised 2/8/2021) 1 Z .