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• <br /> BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 5404 S 3rd Ave PARCEL#: 00500302500200 <br /> clr. Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:AndreW C Sharp <br /> OWNER MAILING ADDRESS: STREET 5404 S 3rd Ave <br /> clr. Everett STATE WA ZIP 98203 <br /> OWNER PHONE:206-355-7302 OWNER EMAIL: ACSharp70@frontier.com <br /> CONTRACTOR COMPANY NAME:OWNER, Andrew C Sharp <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ID OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-355-7302 <br /> Andrew C Sharp CONTACT EMAIL:ACSharp70@frontier.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$65000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:Single Family Residence in R-2 zone <br /> PROPOSED USE OF BUILDING:Single Family Residence in R-2 zone <br /> HEAT SOURCE: ❑Gas ['Electric ❑Other <br /> BUILDING TYPE: EISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): [New Construction ❑Addition ERemodel ['Repair ❑T.I. ['Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ['Exterior Alteration ['Tank(above ground) ❑Accessory Structure <br /> OFence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:Existing Back of House remodel consists of these elements (192 sf): Install underground electrical <br /> service, new service meter, new service disconnects, new main panels, new garage and shed <br /> sub-panels. Remodel the laundry room adding a full bathroom with a toilet, a shower and a vanity sink. <br /> Add Back of House 4" PVC sch 40 sewer line to drain laundry/bathroom room and kitchen. Finish <br /> connecting Back of House sewer and Garage Sewer to 6"main. Remodel Back of House bedroom. <br /> Rebuild existing 2x4 exterior walls and install new hardiplank lap siding. Fully insulate existing concrete <br /> slab. Install perimeter surface drain around South and West edges of existing Back of House concrete <br /> slab. <br /> 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 <br /> 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 <br /> Building 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 application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of EverettEv Official Use Only <br /> Ca-011 g ��0 J)>t-1f�LI PERMIT# ��1 V��O k� <br /> ner/Authorized Agent Signature Date / (Revised 2/8/2021) <br />