2127 100TH ST SE 2024-06-14 - Laserfiche WebLink

• • DECEIVE-1 BUILDING PERMIT APPLICATION JUN 2 8 2023 EVERETT CITY caO EVERETT PERMITforsubSERVICES ITX ()F " �TT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist submittal requirements an r op `F t f5r}eview, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Ceda in $rop Box. CONTACT INFORMATION:(P)425-257-8810 (E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2127 100th st PARCEL#: clr� everett STATE wa ZIP 98208 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):vacant LEGAL DESCRIPTION for^ew construction: Short Playsubdlvision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:francisco garcia OWNER MAILING ADDRESS: 5109 seahurst ave -,-; everett STATE wa zsp 98203 OWNER PHONE:4255 465 7441 OWNER EMAIL: garcia@emplreconStructionlnc.com CONTRACTOR COMPANY NAME: empire construction & remodeling Inc WA STATE CONTRACTOR LICENSE#(REGUIRE:,,aMQ(ke,piiititCITY OF EVERETT BUSINESS LICENSE#(REQUIRED) t(12`5(7' CONTRACTOR ADDRESS: STREETP.O Box 4538 CM' Everett sT'TE WA zip 9 CONTRACTOR PHONE:42546557441 CONTRACTOR EMAIL:garcia@emplreconstruction1nc.com PRIMARY CONTACT: ( OWNER ✓Ci CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: f ra C.CICo CONTACT EMAIL: BUILDING INFORMATION VALUATION OF tRK:5 L ` O © ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall indudeprevailing fair market r . of al labor.materials,and equipment neeced tc co-tpie:e the work,whether actually paid or not.) EXISTING USE OF kUILDING:V9Pant home PROPOSED USE OF BUILDING:Single family home HEAT SOURCE: ❑Gas ✓DElectric ❑Other BUILDING TYPE: D✓SFR DTownhouse DDuplex ❑ADU ❑Mufti-Family-#Units: ❑Commercial DAccessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction (Addition D✓Remodel ✓DRepair DT.I. EChange of Use DModular ❑Portable kiRe-roof Exterior Alteration : Tank(above ground) DAccessory Structure ❑Fence over 7ft high ❑RackStorage _Pool/Hot Tub ETank(above ground) DOther: DESCRIPTION OF WORK:We are adding new roof and closing front entry couryard etc 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 wok 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 06/20/2023 I PERMIT j 0 5 I