2301 EVERETT AVE 2023-09-26 - Laserfiche WebLink

BIDDING PERMIT APPLICATION ECEOVECITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requiremen d number of copies required r view, WASHINGTON then drop off completed application plus all required submittal documents to 3 edar/ ten?F3ntake r Box. CONTACT INFORMATION:(P)425-257-8810 i(E)PermitServices@everettwa.g everettwa.govlpermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION Li IY OF EVERETT PROJECT SITE ADDRESS: STREET 2301 everett eve PARCEL#: Permit services ciry 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:Paul Murrin OWNER MAILING ADDRESS: STREET 2301 everett ave CITY everett STATE Wa ZIP 98201 OWNER PHONE:425-330-8303 OWNER EMAIL: p•murrin@yahoo.com CONTRACTOR COMPANY NAME: WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: C1 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-330-8303 Paul Murrin CONTACT EMAIL:p,rnurrin@yahoo.com BUILDING INFORMATION VALUATION OF WORK:$1000.00 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:home PROPOSED USE OF BUILDING:home HEAT SOURCE: ❑Gas L(Electric ❑Other BUILDING TYPE: ©SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial OAccessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction L�IAddition LJ/Remodel LylRepair OT.I. LiChange of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) OAccessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: rotten wood replacement and wall removal 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 he authorized in writing from the Building Official before being uthorized 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 1 comply with the State ontractors Law 18.27 RCW end 296.200A WAG. City of Everett Official Use Only 2 3 PERMIT# r 0 / n oNa t Signature ' Date (Revised 4/21/2022)