5132 27TH AVE W 2025-01-30 - Laserfiche WebLink

6(. -DING PERMIT APPLICAT )N CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WAS14INGTON 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:Orily:Please) :,.PROJECT'SlTE'iNFORMATION PROJECT SITE ADDRESS: STREET5132 27th Ave West PARCEL M 29043400402700 clTy Everett STATE WA z,p 98203 SUITE/UNIT#: FLOOR M ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short PlaUsubd!vision: Lot No.: (attach copy of long legal description) CON'I"'ACt INFORMATION OWNER NAME: awn 81ack and Anne Hees OWNER MAILING ADDRESS: sTREEr 5132 27th Ave West CITY Everett STATE WA Z,F 98203 OWNER PHONE:425-760-1881 (Anne) OWNER EMAIL: reesadr@aol.com CONTRACTOR COMPANY NAME:PQT Construction WA STATE CONTRACTOR LICENSE#(RE0UIRED):PQTC0C*890NB ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED):51586 CONTRACTOR ADDRESS: ITRIET18915 142nd Ave NE Ste 260 c,rr Woodinville STATE WA Z,P 98072 CONTRACTOR PHONE:888-710-0652 ICONTRACTOR EMAIL:druce@cailpgt.com PRIMARY CONTACT: i]OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:Bruce and Anne CONTACT PHONE:425-319-6953 and 425-760-1881 CONTACT EMAIL:bruce@callpgt.com and reesadr@aoi.com iUILDING:'rNFORMATfON VALUATION OF WORK:$ S see original application 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:Single-family residence PROPOSED USE OF BUILDING:Single-family residence HEAT SOURCE: ZGas ❑Electric ❑Other Heat pomp BUILDING TYPE: ❑✓SFR ❑Townhouse []Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check at/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: Please see Permit B2107-061. This applciation Is for a change in Contractor on the issued permit. Associated permits: M2107-069 and P2108-024 ACKNOWLEDGEMENT.-!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 10/5/22 1 -5 �,t (0 PERMIT# Owner/Authorized Agent Signature Date (Revised 412112022)