3624 UPLAND AVE 2024-06-24 - Laserfiche WebLink

mi BUISNG PERMIT APPLICATIO. 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 3624 Upland Avenue PARCEL#: CITY Everett STATE Washington 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: Andrew Janzen OWNER MAILING ADDRESS: STREET 3624 Upland Avenue CITY Everett STATE Washington ZIP 98203 OWNER PHONE:425-287-1232 OWNER EMAIL: andrew.janzen@gmail.com CONTRACTOR COMPANY NAME: RamJack West 5175 LE 7 WA STATE CONTRACTOR LICENSE#(REQUIRED):RAMJAW*852PW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 19904 Des Moines Memorial Dr. S CITY SeaTac STATE Washington ZIP 98148 CONTRACTOR PHONE: 541-510-9079 CONTRACTOR EMAIL: kelsea@ramjackwest.com PRIMARY CONTACT: 0 OWNER ❑✓ CONTRACTOR ❑✓ OTHER(Please Specify) PermitFlow, Inc. CONTACT NAME: CONTACT PHONE: (470) 660-5261 Eddie Jocusol CONTACT EMAIL: eddiej@permitflow.com BUILDING INFORMATION VALUATION OF WORK: $ 21,964 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: PROPOSED USE OF BUILDING: 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 ❑Portable ❑Re-roof Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑✓Other: Foundation Repair DESCRIPTION OF WORK:Voluntary repair to the existing foundation using 5 helical piles and 3 helical tiebacks D E C IE EI VE') JAN 0 7 2023 2) CITY OF EVERETT Permit Services 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 c ply with State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only e_ e.- - 9-W9-LA., 01/03/2024 PERMIT# Owner/Authorized Agent Sign ture Date (Revised 4/21/2022)