2305 127TH PL SE 2023-12-11 - Laserfiche WebLink

BIDING PERMIT APPLICATON 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 2305 127th PI SE PARCEL#: 00921700000400 CITY Everett STATE WA ZIP 98208 SUITE/UNIT#: NA FLOOR#: 2 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential):NA LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Eastlake Estates Div 1 Phase 2 Lot No.: 4 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Matthew Rafdal OWNER MAILING ADDRESS: STREET 2305 127th PI SE CITY Everett STATE WA ZIP 98208 OWNER PHONE:425-903-1848 OWNER EMAIL: mattrafdal@gmail.com CONTRACTOR COMPANY NAME:Owner WA STATE CONTRACTOR LICENSE#(REQUIRED):NA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): NA CONTRACTOR ADDRESS: STREET NA CITY NA STATE NA zip NA CONTRACTOR PHONE:NA CONTRACTOR EMAIL:NA PRIMARY CONTACT: D OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-903-1848 Matthew Rafdal CONTACT EMAIL:mattrafdal@gmail.com BUILDING INFORMATION VALUATION OF WORK: $5,000.00 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:Residence PROPOSED USE OF BUILDING:Residence 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:Work Includes removal of interior structural wall and replacing with structural beam. Additionally work includes demolition and removal of lower level restroom. 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 Contra .s Law 18.27 RCW and 296.200A WAC. / / / City of Everett Official Use Only 7/ / PERMIT 2-2C)� Owner/Authorized Agent Signature ' Date (Revised 4/21/2022) �/�