3524 W MUKILTEO BLVD 2024-08-02 - Laserfiche WebLink

BuILDING PERMIT APPLICATIuN 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 3524 WEST MUKILETO BLVD. PARCEL#: 00433600004102 CITY EVERETT STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: ESGEWATER Lot No.:42 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:WHITE OWNER MAILING ADDRESS: STREET 3524 WEST MUKILETO BULV. CITY EVERETT STATE WA ZIP 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:NWQRD � WA STATE CONTRACTOR LICENSE#(REQUIRED):NWQUUAQR898JL CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1-Ij CONTRACTOR ADDRESS: STREET15419 SR 9 1 CITY SNOHOMISH STATE WA ZIP 98296 CONTRACTOR PHONE:360-668-0191 CONTRACTOR EMAIL:TERRY@NWQRD.COM PRIMARY CONTACT: 0 OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-668-0191 TERRY WI L L EY CONTACT EMAIL:TERRY@NWQRD.COM BUILDING INFORMATION VALUATION OF WORK:$11,000.00 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:SFR PROPOSED USE OF BUILDING:SFR HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑✓SFR ❑Townhouse EDuplex ❑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) ❑Other: DESCRIPTION OF WORK:14' X 20' NEW CARPORT EcE E R AUG 10 2023 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 circumsta ce.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 thettate Contractors Law 18.27 RCW and 96.200A WAC. City of Everett Official Use Only PERMIT# BIZ Ownlr/ thorized A ent Sig ature Date (Revised 4/21/2022)