5316 ROCKEFELLER AVE 2025-03-10 - Laserfiche WebLink

NMI BuILDING PERMIT APPLICATI JN 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 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5316 ROCKEFELLER AVE PARCEL#: 00495800601400 CITY 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:DANIEL HULTS OWNER MAILING ADDRESS: STREET 5316 ROCKEFELLER AVE CITY EVERETT STATE WA ZIP 98201 OWNER PHONE:425.923.3589 OWNER EMAIL: D_HULTS@a HOTMAIL.COM CONTRACTOR COMPANY NAME:TBD Vliesrb /14tyi t u-IA WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY Lida it 1. S\lititt14 STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) ARCHITECT CONTACT NAME: CONTACT PHONE:206.931.0990 GA R I N Sc H E N K CONTACT EMAIL:GARIN@ARCHSTUDIOEVERETT.COM BUILDING INFORMATION VALUATION OF WORK: $90,000.00 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:SINGLE FAMILY RESIDENTIAL PROPOSED USE OF BUILDING:SINGLE FAMILY RESIDENTIAL 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 CRepair CT.I. CChange of Use [IModular EPortable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure CFence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) COther: DESCRIPTION OF WORK:674 SF ADDITION TO AN EXISTING SFR, ALONG NORTH SIDE OF HOUSE. A COVERED ENTRY WILL ALSO BE ADDED. REMOVING PORTIONS EXISTING PATIO TO REMAIN UNDER 200 SF NET NEW IMPERVIOUS. 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 focal 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 l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only • PERMIT# 62 to Owner/Auttjorized Agen ignature Date (Revised 2/8/2021) ,,JJ i