627 103RD PL SE 2023-12-11 - Laserfiche WebLink

BUILDING PERMIT APPLICATION r.EMAY 16 2023 EVERETT SUBMITTAL INSTRUCTIONS: See CITY OF EVERETT PERMIT SERVICES applicable submittal checklist for submittal requirements an ^ of//copie5 r r uj �• w, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar�y[I�tTln 0 - 4 •p Box. CONTACT INFORMATION:(P)425-257-8810 l(E)PermitServices@everettwa.gov l(W)everEpent it VICeS (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 627-103rd Place SE PARCEL#: 00535000000100 cln Everett STATE WA ZIP 98208 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:Joseph Miller OWNER MAILING ADDRESS: STREET 15703 48th Ave. W. CITY Everett STATE WA zip 98026 OWNER PHONE:425-876-5196 OWNER EMAIL: j•miller68@comcast.net CONTRACTOR COMPANY NAME:WHD LYNNWOOD RENOVATIONS - Albert Brito WA STATE CONTRACTOR LICENSE#(REQUIRED):WHDRERL783DH CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54135 CONTRACTOR ADDRESS: STREET 14523 Hwy 99, Suite#9 cln Lynnwood STATE WA zip 98087 CONTRACTOR PHONE:425-775-6123 ext. 800 CONTRACTOR EMAIL:albert@whd.rocks PRIMARY CONTACT: El OWNER L..CONTRACTOR ✓ OTHER(Please Specify) Agent for Owner CONTACT NAME: CONTACT PHONE:206 281 7500 Chris Bacus-Pacific Engineering Tech. CONTACT EMAIL:cbacus@ pacengtech.com BUILDING INFORMATION VALUATION OF WORK: $35,000 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:Single Family Residence PROPOSED USE OF BUILDING:No Change HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: OSFR ❑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 ._IPortable ❑Re-roof ❑Exterior Alteration ,_,'Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:THIS PERMIT IF FOR THE REPAIRS FOR THE DAMAGE CAUSED BY A RECENT VEHICLE IMPACT AT THE SUBJECT RESIDENCE IN EVERETT,WASHINGTON. THE SCOPE OF WORK IS TO REPAIR THE DAMAGE TO THE HOUSE IN-KIND,THERE ARE NO ALTERATIONS OR ADDITIONS. THE SCOPE OF WORK CONSISTS OF THE FOLLOWING: -REMOVE AND REPLACE THE DAMAGED WALL FRAMING ALONG THE SOUTH ELEVATION,APPROXIMATELY 15'. -REMOVE AND REPLACE THE DAMAGED INTERIOR FINISHES, FIXTURES, INSULATION,AND WINDOWS AS REQUIRED. THERE IS NO INCREASE IN THE EXISTING BUILDING FOOTPRINT, SQUARE FOOTAGE OR HEIGHT. 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 Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 5/12/23 PERMIT# B25 - NI 3 Owner/Authorized Agent Signature Date (Revised 4/21/2022)