7430 BEVERLY LN 2023-09-25 - Laserfiche WebLink

B(DING PERMIT APPLICAN 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 7430 Beverly Lane PARCEL#: 00392000001303 ciTy 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: BEVERLY ACREAGE TRACTS Lot No.: 2 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Olin &Gail Fox do Bryant Corbin OWNER MAILING ADDRESS: STREET 205 76th St. S.E. co-v Everett STATE WA ZIP 98203 OWNER PHONE:425-359-5962 OWNER EMAIL: skilletup@hotmail.com CONTRACTOR COMPANY NAME:Kustom US -Tae Kim WA STATE CONTRACTOR LICENSE#(REQUIRED):K14 TO U 1.54174)a CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 36 Z D3 CONTRACTOR ADDRESS: STREET 14253 169th Drive SE, #503 CITY Monroe STATE WA ZIP 98272 CONTRACTOR PHONE:425-766-7444 CONTRACTOR EMAIL:Tae.Kim@kustom.us PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR EI OTHER(Please Specify) Agent for Owner CONTACT NAME: CONTACT PHONE:206-281-7500 Chris Bacus-Pacific Eng. Tech. CONTACT EMAIL:cbacus@pacengtech.com BUILDING INFORMATION VALUATION OF WORK: $ • IZt 700 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:Single Family Residence PROPOSED USE OF BUILDING:No Change 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:THIS PERMIT IS FOR THE REPAIRS FOR THE DAMAGE CAUSED BY A LOW-SPEED VEHICLE IMPACT TO THE FOX RESIDENCE LOCATED IN EVERETT, WASHINGTON. THE SCOPE OF WORK IS TO REPAIR THE FOLLOWING: • REMOVE AND REPLACE THE DAMAGED BRICK MASONRY VENEER • REPAIR DISLODGED WALL FRAMING AND DAMAGED SHEATHING. THERE IS NO CHANGE IN THE EXISTING BUILDING FOOTPRINT. 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 PERMIT# 226) 1 ,�Q6 2/3/22 Owner/Authorized Agent Signature Date (Revised 2/8/2021)