5901 FLEMING ST 2024-02-16 - Laserfiche WebLink

• BUILDING PERMIT APPLICATION 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 (E)everetteps@everettwa.gov l(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREEt 5901 Fleming PARCEL#: CITY Everett STATE Wa ZIP 98203 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:Daniel Reuben Haupt and Chantile M. Haupt OWNER MAILING ADDRESS: STREET 5901 Fleming St °TY Everett STATE Wa TIP 98203 OWNER PHONE:8148529267 OWNER EMAIL: haupt.dr@gmail.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: 0 OWNER i_i CONTRACTOR E OTHER (Please Specify) CONTACT NAME: CONTACT PHONE:81 48529267 Reuben Haupt CONTACT EMAIL:haupt.dr@gmail.com BUILDING INFORMATION VALUATION OF WORK: $ ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall Include the prevailing pair market value of at labor.materials.and equipment needed to complete the work.whether actually paid or not.) EXISTING USE OF BUILDING:Residential PROPOSED USE OF BUILDING:Residential HEAT SOURCE: `;Gas (✓[Electric LLOther BUILDING TYPE: ✓'ISFR [._'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 -_1Modular C.Portable [_IRe-roof ❑Exterior Alteration '❑Tank(above ground) ❑Accessory Structure f_.lFence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank (above ground) )1Other:repair unpermitted work DESCRIPTION OF WORK:Re-issue of owl 603-005 to close out the removal of unpermitted construction of basement appartment. 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 VI/AC. City of Everett Official Use Only �-� // V 12:;z, P ITCoR _mu( Owner/Authorizetl Agent Si ature Date (Revised 2/8/202 f)