1010 93RD ST SW 2024-12-30 - 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)everetteps@everettwa.gov I (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1010 93rd St SW PARCEL M 00534000003100 CITY Everett STATE WA ZIP 98204 SUITE/UNIT M FLOOR M 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: Ricky Lee & Martha Florentina OWNER MAILING ADDRESS: STREET 1010 93rd St SW CITY Everett STATE WA ZIP 98204 OWNER PHONE: 425-202-1 593 1OWNER EMAIL: rlCky.a.lee@aol.com CONTRACTOR COMPANY NAME: Evergreen Seismic, LLC WA STATE CONTRACTOR LICENSE#(REQUIRED): EVERGSL823JF I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 61248 CONTRACTOR ADDRESS: STREET 21304 82nd PI SE CITY Snohomish STATE WA ZIP 98290 CONTRACTOR PHONE: 206-715-3957 1CONTRACTOR EMAIL: Info@evergreenseismic.com PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-715-3957 Matt Robinson CONTACT EMAIL: info@ evergreenseismic.com BUILDING INFORMATION VALUATION OF WORK: $5000 1ASSOCIATED 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 ❑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: DESCRIPTION OF WORK: Voluntary seismic retrofit upgrade to crawlspace of SFR, per Seattle's "Project Impact" prescriptive plan set, (SEHR). No earth disturbance. 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 W104 90_� PERMIT# 7/14/24 Owner/Authorized Agent Signature Date (Revised 21812021)