625 93RD ST SW 2025-05-22 - Laserfiche WebLink

wowi�■�I BUIOING PERMIT APPLICATIll CITY OF EVERETT PERMIT SERVICES ECEIVIE1 EVERETTSUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements an mber of copies required for reWASHINGTON then drop off completed application plus all required submittal documents to 3200 r Str-:a dFIQor)nt�ke Drop . CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I vere - !o / (Blue or Black Ink Only Please) PROJECT SITE INFORMATION CITY OF EVERETT PROJECT SITE ADDRESS: STREET 625 93rd STREET SW PARCEL#: 0053390+ . Q SPrVirt^eseS cnv EVERETT STATE WA. ZIP 98204 SUITE/UNIT#: NA FLOOR#: NA 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: MARGARET RALSTON OWNER MAILING ADDRESS: STREET 625 93rd STREET SW crry EVERETT STATE WA. zap 98204 OWNER PHONE: 360-672-0901 OWNER EMAIL: skelliebunnie@gmail.com CONTRACTOR COMPANY NAME: Buiki-SDG (D Ate 65 Si40 WA STATE CONTRACTOR LICENSE#(REQUIRED) BUILT**814QM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): TBD CONTRACTOR ADDRESS: STREET 3503 SMUGGLER'S COVE ROAD cm GREENBANK STATE WA. ziP 98253 CONTRACTOR PHONE: 206-679-0164 CONTRACTOR EMAIL: buildsdg@outlook.com lAke.Y 1,te.F VG PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ■OTHER(Please Specify)Architectural Designer Qlvk CONTACT NAME: SCOTT J. JOHNSON CONTACT PHONE: 206-696-1078 CONTACT EMAIL: scott^johnson222@outlook.com BUILDING INFORMATION VALUATION OF WORK:$ $150,000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevaitng 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 RESIDENTIAL PROPOSED USE OF BUILDING:SINGLE FAMILY RESIDENTIAL HEAT SOURCE: ❑Gas ■Electric ■Other MINI-SPLIT HEAT PUMP BUILDING TYPE: •SFR ❑Townhouse ❑Duplex DADU DMulti-Family-#Units: ❑Commercial DAccessory Structure TYPE OF PROJECT(check all that apply): DNew Construction •Addition DRemodel DRepair DT.I. ❑Change of Use [Nodular DPortable ❑Re-roof DExterior Alteration ❑Tank(above ground) DAccessory Structure OFence over 7ft high DRackStorage ❑Pool/Hot Tub ❑Tank(above ground) DOther: DESCRIPTION OF WORK: ONE BEDROOM, ONE BATH AND CARPORT ADDITION TO EXISTING SINGLE FAMILY RESIDENCE. 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.lam 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 01°f , 04! 1 D I YD / PERMIT# f et✓ L'J r .ith ze Age nature Date (Revised 4/21/2022)