5030 27TH AVE W 2024-11-08 - Laserfiche WebLink

BUILDING PERMIT APPLICATION 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 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5030 27TH AVE W PARCEL#: 29043400403700 clTv EVERETT STATE WA ZIP 98203-1437 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:Samuel Herbst OWNER MAILING ADDRESS: STREET 5030 27TH AVE W cIn. 5030 27TH AVE W STATE WA zIP 5030 27TH AVE W OWNER PHONE:401-H64-6586 IOWNEIR EMAIL: Sam.herbSt@gmail.COm CONTRACTOR COMPANY NAME:Legacy Decking LLC L 7 5 WA STATE CONTRACTOR LICENSE#(REQUIRED):LEGACDL775QP I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): LEGACDL7750P CONTRACTOR ADDRESS: STREET6105 48TH ST NE clry MARYSVILLE STATE WA ZIP 98270 CONTRACTOR PHONE:425-212-7740 1CONTRACTOR EMAIL:daVid@legacydecking.CO PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Designer CONTACT NAME: CONTACT PHONE:425-343-8942 Ilia Petrenko CONTACT EMAIL:ilia@ipdesign.group BUILDING INFORMATION VALUATION OF WORK:$10000 ASSOCIATED LAND USE PROJECT#(if applicable): (valuation shall indude 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:living PROPOSED USE OF BUILDING:living HEAT SOURCE: ❑✓Gas ❑Electric [-]Other BUILDING TYPE: ❑✓SFR ❑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:deck low DESCRIPTION OF WORK:replace existing deck like-to-like JUN 1 1 2024 CITY OF EVERET-I t Se maces Perm 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 1 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 6/6/2024 PERMIT# Owner/Authorized Agent Signature Date (Revised 412112022)