3413 COLBY AVE 2023-06-16 - Laserfiche WebLink

BRLDING PERMIT APPLICATItN CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASH I NGTON 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 l(E)everetteps@everettwa.gov l(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 3413 Colby Ave PARCEL#: 00436982200700 cl,-y Everett STATE WA 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:Kevin Wick OWNER MAILING ADDRESS: STREET 105 185th PI SW CITY Bothell STATE WA ZIP 98012 OWNER PHONE:425-232-6263 OWNER EMAIL: kevin@kevinwick.com CONTRACTOR COMPANY NAME:Owner WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: OC42....) PRIMARY CONTACT: D OWNER ❑CONTRACTOR ❑OTHER(Please Specify) e-A-t. L.E1S —WA'`-- CONTACT NAME: CONTACT PHONE:425-232-6263 Kevin Wick CONTACTEMAIL:kevin@kevinwick.com s a- cam, BUILDING INFORMATION • VALUATION OF ORK:$10-0,00 d /i u ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair merKet val of all Tabor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING US4OF BUILDING:Sing e Family residence PROPOSED Us1sOF BUILDINGSingle Family Residence 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) EAccessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: t -Rew cabinets and-walls= -Qug a-• inc-ludincybatntoom& N le 'ate v s 10 o (.)w tJ O .r-s 1- Sec1 r \ ke-ac) S 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 " L. Q C Zo ZZ PE �� LJ � # 2 Own " Owner/Authorized Agent Signature Date (Revised 2/8/2021)