1613 ORCA VIEW LN 2025-08-14 - Laserfiche WebLink

E ULDING PERMIT APPLICATIQN EVERETT CITY OF EVERETT PERMIT SERVICES 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 i(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1613 Orca View Ln PARCEL#: 00733800002500 crry Everett STATE We. zip 98203-1671 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdMslon: Edgemoor Heights Lot No.: 25 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Nathan&Grecia Bement OWNER MAILING ADDRESS: STREET 1613 Orca View Ln crry Everett STATE We ZIP 98203-1871 OWNER PHONE: 253-221-5659 OWNER EMAIL: nathanbement@gmail.com CONTRACTOR COMPANY NAME:Ashworth Homes 6 3 7-3'1 WA STATE CONTRACTOR LICENSE#(REQUIRED):ASHWOHL950JL Crry OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: sTREEr 1501 N.200th St crry Issaquah STATE We. ZIP 98133 CONTRACTOR PHONE:206-715-9552 CONTRACTOR EMAIL:erich@ashworthhomes.com PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR m OTHER(Please Specify) RVJ Permit Consuhhcg,Ron Jacobson CONTACT NAME: CONTACT PHONE:206-510-5931 Ron Jacobson CONTACT EMAIL:ronjacobson65@gmall.com BUILDING INFORMATION VALUATION OF WORK:$100000 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:Residential PROPOSED USE OF BUILDING:Residential HEAT SOURCE: ❑Gas (Electric ❑Other BUILDING TYPE: mSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): :New Construction 10Addition ❑Remodel ❑Repair ❑T.l. ❑Change of Use ❑Modular ❑Portable ORe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ORackStorage OPool/Hot Tub OTank(above ground) ❑Other: DESCRIPTION OF WORK: Add 416 sf of additional living space to the second floor. Addition will be over the existing first floor. ACKNOWLEDGEMENT:i have reviewed this application and confirm the informetkrn 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 end no deviations therefrom.Deviations must first be authorized in wilting from the Building Of9cial 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 RC W and 296 200A WAC. City of Everett Official Use Only PERMIT# 522-0 S 013 Ron Jacobson "", ,"; AVOW , Owner/Authorised Agent Signature Date (Revised 2/8/2021) II Y /2