5019 COLBY AVE 2024-08-02 - Laserfiche WebLink

Nim Bl- DING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL 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((E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5019 Colby Ave PARCEL#: 00377500000800 cry 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: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: David Schuerman OWNER MAILING ADDRESS: STREET SAME AS SITE ADDRESS CITY STATE ZIP OWNER PHONE: 425-422-1687 OWNER EMAIL: ddschuerm@yahoo.com CONTRACTOR COMPANY NAME: Seahawk Remodeling WA STATE CONTRACTOR LICENSE#(REQUIRED): SEAHARL882MP CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 94137 CONTRACTOR ADDRESS: STREET 11108 17TH CT W CITY Everett STATE WA zip 98204 CONTRACTOR PHONE: (425) 341-4517 CONTRACTOR EMAIL: Seahawkleads@gmail.com PRIMARY CONTACT: CI OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-422-1687 David Schuerman CONTACT EMAIL: ddschuerm@yahoo.com BUILDING INFORMATION VALUATION OF WORK: $ 12,672 (from fee schedule) 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: Personal Residence PROPOSED USE OF BUILDING: HEAT SOURCE: k Gas ❑Electric ❑Other BUILDING TYPE: 1SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): II-New Construction ❑Addition ❑Remodel ❑Repair (-1T.1. ❑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: 2nd Level Deck DESCRIPTION OF WORK: Install second level deck, 12'x16, with no stairs. Deck surface is solid surface lywood with membrane cover. EC FIVE D JUL 19 2023 CITY OF EVERETT Pe►mit Ccrvioec 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 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only dear 7 / 7_e7 PERMIT# 6)3 0.7 ner/Authorize gent Signaturle Date (Revised 4/21/2022)