2712 HEWITT AVE 2024-06-21 - Laserfiche WebLink

Ism BUILOIG PERMIT APPLICATIG ' 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 l(Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2712 HEWITT AVE PARCEL#: 00593669300300 CITY EVERETT STATE WA zip 98201 SUITE/UNIT#: FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): Y W-iw-Pn.i -5-� LL-G LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:BRIAN BODGE � � AV toe, .-37.2N w5-F R OWNER MAILING ADDRESS: STREET 3007 EVERETT AVE �c CITY EVERETT STATE WA ZIP 98201 OWNER PHONE: 4Z5 79-3+3 OWNER EMAIL: BRIANBODGE@MSN.COM CONTRACTOR COMPANY NAME:OWNER WA STATE CONTRACTOR LICENSE#(REQUIRED):N/A CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): N/A CONTRACTOR ADDRESS: STREET N/A CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) � CONTACT NAME: CONTACT PHONE: 4-Z5—87y9—34.3 4 BRIAN BODGE CONTACT EMAIL:BRIANBODGE@MSN.COM BUILDING INFORMATION VALUATION OF WORK: $5,000 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:RETAIL PROPOSED USE OF BUILDING:NO CHANGE HEAT SOURCE: EGas XFlectric ❑Other BUILDING TYPE: ❑SFR Townhouse ❑Duplex ❑ADU EMulti-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) 11O her. TOILET ROOM ONLYT.I. DESCRIPTION OF WORK:TENANT IMPROVEMENT OF EXISTING TOILET ROOM. RIEVEIVEr DEC 14 212 3 J CITY ': Ili}- CTT ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done p Ps I,.en Fd Vkis-pbr�nll P71 tbmply 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 1 comply with the State Contractors L 18.27 RC and 296.200A WAC. City of Everett Official Use Only Z 872_02 3 PERMIT Owner/Authorized Agent Signature Date (Revised 4/21/2022)