2503 MADISON ST 2023-09-26 - Laserfiche WebLink

BM • in BUILDING PERMIT APPLICATION �!E R E T T CITY OF EVERETT PERMIT SERVICES :� 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 2503 Madison St PARCEL#: 00544701300901 cln Everett STATE WA ZIP 98203 ISUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Barrett Holdings LLC 1LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of lona legal description) CONTACT INFORMATION OWNER NAME:John Barrett OWNER MAILING ADDRESS: STREET 2503 Madison St L"ITY Everett STATE WA ZIP 98203 OWNER PHONE:206-300-4081 OWNER EMAIL: barrettholdingsllc@gmail.com CONTRACTOR COMPANY NAME: ;WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 1 CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR C✓1 OTHER(Please Specify) Engineer CONTACT NAME: CONTACT PHONE:206-713-9915 Peter Lundquist CONTACT EMAIL:peter.lundquist@taec.net I BUILDING INFORMATION VALUATION OF WORK: $12000 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:Commercial .PROPOSED USE OF BUILDING:Commercial HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: USER ❑Townhouse ❑Duplex ❑ADU ❑✓Multi-Family-#Units:4 ❑✓Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. EChange of Use ❑Modular ❑Portable ❑✓Re-roof ✓❑Exterior Alteration ETank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ETank(above ground) ❑Other: DESCRIPTION OF WORK: Removal of exterior decks, replacement of sliding door with window. Re-roofing. IECE[IVE i--- 1 , SEP 0 8 2021 _L21) ACKNOWLEDGEMENT.'I have reviewed this application and confirm the information contained herein is true and correct. Work done/iatslu nt'to tMsFer t`ITR�sPcbh�pt��Jith current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations musJeV4'I Inri+vl♦I'®es 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!comply with the State Contractors Law 18.27 RCW and 295.200A WAC. 0/7,40Z1( of Everett Official Use Only PEZ#151/4.09. —cao Co OvIner/Authgft'ze gent Signature Date (Revised 2/8/2021)