3322 KROMER AVE 2023-05-26 - Laserfiche WebLink

BL*DING PERMIT APPLICATI9 EVERETT WASHINGTON CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, 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 1 (E) everetteps@everettwa.gov i (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 3xxx Kromer Street yY'PARCEL M 00583978301402 c„y Everett STATE WA ZIP 98201 SUITE/UNIT #: FLOOR M ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: fiore.pig nataro@rsir.COm Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Dick Kikuchi OWNER MAILING ADDRESS: STREET 815 34th ST CITY Everett STATE WA ZIP 98201 OWNER PHONE: [OWNER EMAIL: CONTRACTOR COMPANY NAME: Haack Brothers Homes WA STATE CONTRACTOR LICENSE #(REQUIRED):HaackBI012DZ ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 053967 CONTRACTOR ADDRESS: STREET3922 87th AVE NE cl, Marysville STATE WA zip 98270 CONTRACTOR PHONE:425-290-2429 1CONTRACTOR EMAIL:joel@haackbrothers.Com PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: J oe I Haack CONTACT PHONE:425-290-2429 CONTACT EMAIL:joel@haackbrothers.com BUILDING INFORMATION VALUATION OF WORK: $$400,000 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: PROPOSED USE OF BUILDING:SFR HEAT SOURCE: ❑Gas ❑✓ Electric ❑Other BUILDING TYPE: OSFR ❑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: Construct New SFR with attached garage 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. I am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, and I comply with State Contractors La 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERM `(D Owner/Authorized Agent Signature Date (Revised 21812021) i