3004 17TH ST 2023-06-23 - Laserfiche WebLink

_ • • 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, WASHINQTON 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 3004 17th ST Ne PARCEL#: 00605400400800 an. 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:Rick Hernandez OWNER MAILING ADDRESS: STREET See Project Site Address CITY STATE ZIP OWNER PHONE:425-583-8062 OWNER EMAIL: alesha@rrspecialist.net CONTRACTOR COMPANY NAME:R&R Foundation Specialist WA STATE CONTRACTOR LICENSE#(REQUIRED):RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 3409 Mcdougall Ave Suite 204 CITY Everett STATE WA zip 98201 CONTRACTOR PHONE:425-760-5077 CONTRACTOR EMAIL:permits@rrspecialist.net PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑✓ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-583-8062 Ales h a Sti ckl es CONTACT EMAIL:alesha@rrspecialist.net BUILDING INFORMATION VALUATION OF WORK:$13,600.00 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:SFR PROPOSED USE OF BUILDING:No changes HEAT SOURCE: ElGas ElElectric ❑Other BUILDING TYPE: ©SFR ❑Townhouse EDuplex ❑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: Installation of helical piles to stabilize the foundation after settling 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/am authorized by the owner of this property to perform the work for which application is made, and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Alesha Stickles Dae:l 0220608y12101h55-t0700' PERMIT# - Owner/Authorized Agent Signature Date (Revised 4/21/2022) Y0_