2410 EVERETT AVE 2024-02-20 - Laserfiche WebLink

NNE iz BIDING 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 I (E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2410 Everett Ave PARCEL#: 00437863300500 cnTv Everett STATE WA ZIP 98201 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:Jorge and Regina Chacon OWNER MAILING ADDRESS: STREET 2410 Everett Ave. CITY Everett STATE WA ZIP 98201 OWNER PHONE:206-370-0811 OWNER EMAIL: reginachacon@yahoo.com CONTRACTOR COMPANY NAME:Jorge-ehacon az( i U-2____ WA STATE CONTRACTOR LICENSE#(REQUIRED):Owner CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): NSA CONTRACTOR ADDRESS: STREET 2410 Everett Ave crry Everett STATE WA zIP 98201 CONTRACTOR PHONE:206-852-07355 CONTRACTOR EMAIL:)orChago@yahoo.com PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) Regina Chacon CONTACT NAME: Regina Chacon CONTACT PHONE:206-370-0811 CONTACT EMAIL:reginachacon@yahoo.com BUILDING INFORMATION VALUATION OF WORK:$7,000 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:single family 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 ETA. ❑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: Remove and replace the existingroofingmaterials J p ' iI,LJ'LG' r C C2Z2‘l T6?-e k �(i ( h G re kilo red ail.e re_. ZGt- ' e_L%I , 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 2 . '1") ./ PEZI-#2 • Li 7./ , #I' 2 Z_ 2--kp--0?---C\i Owner/Authorized Agent Signature Date (Revised 4/21/2022)