4920 24TH AVE W 2023-06-22 - Laserfiche WebLink

ix ft BIDING PERMIT APPLICAT 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 4920 24th Ave. W. PARCEL#: 00567900400402 cm( 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: Seaview Heights Lot No.:2 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:4900 24th Ave. W., LLC OWNER MAILING ADDRESS: STREET 526 N. West Ave. #147 cITY Arlington STATE WA ZIP 98223 OWNER PHONE:360-631-5922 x 3 OWNER EMAIL: officemanager@fullwilerconstruction.com CONTRACTOR COMPANY NAME:Fullwiler Construction Inc. WA STATE CONTRACTOR LICENSE#(REQUIRED):FULLWCI9O3M2 CITY OF EVERETT BUSINESS LICENSE#(REQUI • CONTRACTOR ADDRESS: STREET526 N. West Ave. #147 r;i0)_,Sk, CITY Arlington STATE WA ZIP 98223 CONTRACTOR PHONE:360-631-5922 x 3 coNTRAc-roRficemanager@fullwilerconstruction.com PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-631-5922 x 3 /425-344-7803 Mallorie Hefley or Jerry Fullwiler CONTACT EMAIL:officemanager@fullwilerconstruction.com BUILDING INFORMATION VALUATION OF WORK:$300,000 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:None - new construction PROPOSED USE OF BUILDING:Single family home 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) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:Construct new 2-story single family home with attached garage 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 properly 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 ,-- "7 a 0 (&, -OLA CO Owner/Authorized Agent Si gnat re / Date (Revised 2/8/2021 9 9 ) i