1424 MADRONA AVE 2023-08-08 - Laserfiche WebLink

BUILDING PERMIT APPLICATRN 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 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1424 Madrona Ave PARCEL #: 00505700002600 CITY Everett STATE wa ZIp 98203 SUITE/UNIT #: NA FLOOR #: NA ADDITIONAL LOCATION INFORMATION (if applicable): NA TENANT/BUSINESS NAME (if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: MAPLE HEIGHTS BLK 000 D-00 Lot No.: 26 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Karst Brandsma OWNER MAILING ADDRESS: STREET 1424 Madrona Ave CITY Everett STATE WA ZIP 98203 OWNER PHONE:425-923-6234 IOWNEIR EMAIL: kbrandsma@comcast.net CONTRACTOR COMPANY NAME:owner will do work WA STATE CONTRACTOR LICENSE #(REQUIRED): NA CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): NA CONTRACTOR ADDRESS: sTREETNA crry NA STATE NA zip NA CONTRACTOR PHONE: NA CONTRACTOR EMAIL: NA PRIMARY CONTACT: 0 OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Karst B ra n d s m a CONTACT PHONE:425-923-6234 CONTACT EMAIL: kbrandsma@comcast.net BUILDING INFORMATION VALUATION OF WORK: $$2500-$3000 ASSOCIATED LAND USE PROJECT # (if applicable): NA (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: Residential PROPOSED USE OF BUILDING: Residential 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: non -insulated garage ceiling to be insulated with R38 batt insulation and covered with 5/8" Type X GWB and replace porcelain-1-1Ov electical sockets with-LCD shop lights To 66 0`?L f t-D Fo CZ 00 5E_e 4*A-YL'- 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. 1 am the owner, or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Owner/Authorized Agent Signature 3/30/2023 Date City of Everett Official Use Only PERMIT # 32 S(Wvl� (Revised 412112022)