1005 NORTH PARK DR 2023-05-19 - Laserfiche WebLink

BIDING PERMIT APPLICATI*1 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 1005 N Park Dr PARCEL#: 00464700003200 CITY 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: Harbor View Add to Everett Lot No.: 32 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Alan Kobuke OWNER MAILING ADDRESS: STREET 1005 N Park Dr SIT, Everett STATE WA zip 98203 OWNER PHONE:206-369-4601 OWNER EMAIL: akobuke@frontier.com CONTRACTOR COMPANY NAME:Matvey Foundation Repair WA STATE CONTRACTOR LICENSE#(REQUIRED):Matvefr837k5 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 056264 CONTRACTOR ADDRESS: STREET 18915 16th Ave S crry Seatac STATE WA ZIP 98188 CONTRACTOR PHONE: 253-327-1650 CONTRACTOR EMAIL:permits@gomatvey.com PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-660-7971 Ayd e n Wagner CONTACT EMAIL:permits@gomatvey.com BUILDING INFORMATION VALUATION OF WORK:$19,830.00 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:Single Family Residence PROPOSED USE OF BUILDING:No change HEAT SOURCE: EGas ❑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) Mother:Foundation Repair Only DESCRIPTION OF WORK: Installing 5 push piers and 12 stabilizer systems under the existing foundation for stabilization. No additions, no change in footprint. 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 Aden Wagner DigitallysignedbyAydenWagner, PERMIT# 2 Ac2..,YDae:2022.08.2910:07:21-0T00' 8�29�22 Owner/Authorized Agent Signature Date (Revised 4/21/2022)