1719 125TH PL SE 2023-10-31 - Laserfiche WebLink

BUILDING PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINOTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box, CONTACT INFORMATION:(P)425-257-88101(E)PermltServices@everettwa.gov I(W)everettwa.gov/pormits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1719 125th PL SE PARCEL It: 00399300000800 cny Everett STATE WA zla 98208 SUITEIUNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): TENANTIBUSINESS NAME(if non-residentlal): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Sean Klein OWNER MAILING ADDRESS: STREET 1719 125TH PL SE cfry Everett STATE WA 21n 98208 OWNER PHONE:206-696-3845 1OWNER EMAIL: sean.klein@gmail.com CONTRACTOR COMPANY NAME:AChten'S Quality Roofing WA STATE CONTRACTOR LICENSE#(REQUIRED):ACHTEQR923CM CITY OF EVERETT BUSINESS LICENSE 1t(REQUIREO): 53951 CONTRACTOR ADDRESS: STREET410 112th ST S cm Tacoma STATE WA z1F, 98444 CONTRACTOR PHONE:253-254-4835 CONTRACTOR EMAIL:brandon@achtenst,00fing.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-254-4835 Brandon Foster ICONTACT EMAIL:brandon@aciitensroofing.com BUILDING INFORMATION VALUATION OF WORK:$29,305 1ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall Include the prevailing fair market value of al labor,maledals,and equipment needed to Complete Ute verk,vAleUler actually poki or not.) EXISTING USE OF BUILDING:Residential PROPOSED USE OF BUILDING:Residential HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑✓SFR ❑Townhouse ❑Duplex ❑ADU ❑Muhl-Famliy-#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 Drank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub []Tank(above ground) ❑Othor: DESCRIPTION OF WORK:Residential re-roof. Remove old roofing materials. Install new plywood sheeting, synthetic underlayment, stormshield; over entire roof, edge metals, valley metals, flashings, roofing accessories, and comp' shingles. ACKNOWLEDGEMENT:I have revlewed this application and confirm the Infomlallon contained heroin Is true and correct.Work done pursuant to this permit must comply with currant federal,slate,and local law.The granting of a ponnit only authorizes approved work and no deviations therefrom.Deviations must Asst be authorized In writing from the .13uilding 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 applicatlml Is mode, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only [77 norlAuthor zed l /0 J o w Agent Signature Data (Revised 4/21/2022)