6110 COMMERCIAL AVE 2023-09-26 - 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, 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) everetteps@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 6110 COMMERCIAL AVE PARCEL M 0544900601200 CITY EVERETT STATE WA z,P 98203 SUITE/UNIT #: NONE FLOOR M 1 ADDITIONAL LOCATION INFORMATION (if applicable): NONE TENANT/BUSINESS NAME (if non-residential): NONE LEGAL DESCRIPTION for new construction: Short Plat/subdivision: PINEHURST DIV Lot No.: 12 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: QUAN MINH TO OWNER MAILING ADDRESS: STREET 12428 SE 27TH STREET CITY BELLEVUE STATE WA zIP 98005 OWNER PHONE: 1 (206) 300-4093 OWNER EMAIL: quanminhto@gmall.Com CONTRACTOR COMPANY NAME: by owner WA STATE CONTRACTOR LICENSE #(REQUIRED): CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: El OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) Designer CONTACT NAME: TUAN AN H TRAN CONTACT PHONE:(253)224-5592 CONTACT EMAIL: tyhon@yahoo.com BUILDING INFORMATION VALUATION OF WORK: $ 50,000 ASSOCIATED LAND USE PROJECT # (if applicable): none (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: yes PROPOSED USE OF BUILDING: none HEAT SOURCE: [-]Gas DElectric ❑Other BUILDING TYPE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT (check all that apply) : ❑New Construction ❑Addition ❑Remodel ORepair ❑T.I. ❑Change of Use ❑Modular [-]Portable ORe-roof ❑Exterior Alteration [-]Tank (above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub [-]Tank (above ground) ❑Other: DESCRIPTION OF WORK: the house had accident to fire. 5% damage. Need replace 3 wood beam burn out, and some 2x4 damage. Replace the new roof, new floor, new electric hot water tank, new electric wire, new heater, new bathtub, sink, new Pex plumbing. new windows, new doors, and new insulation hit the enegy code 2018. 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 1 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. 2/2/2022 Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT # (Revised 21812021)