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• <br /> E BUILDING PERMIT APPLICATI!N <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETTSUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2303 EVERETT AVE PARCEL#: 00437860501102 <br /> ciTY EVERETT STATE WA Zip 98201 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: DIV I PLAT OF BLK 605 D-02 Lot No.:r "`oT„xwz3 0* (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:CHAUDIERE ARON D& SAMANTHA J <br /> OWNER MAILING ADDRESS: STREET 2303 EVERETT AVE <br /> CITY EVERETT STATE WA zip 98201 <br /> OWNER PHONE:425-232-5929 OWNER EMAIL: arondchaudiere@gmail.com <br /> CONTRACTOR COMPANY NAME:Town & Country Post Frame Buildings <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):TownCPF099LT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 12646 <br /> CONTRACTOR ADDRESS: STREET 16521 Hwy 99 Suite C <br /> CITY Lynnwood STATE WA Zip 98037 <br /> CONTRACTOR PHONE:425-743-1555 CONTRACTOR EMAIL:permits@permabilt.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425 743 1555 <br /> Town & Country Post Frame Buildings CONTACT EMAIL:permits@permabilt.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$$50,473.66 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING: <br /> PROPOSED USE OF BUILDING:773 sf pole garage, no heat or plumbing <br /> HEAT SOURCE: ❑Gas ❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑✓Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ✓❑New Construction ❑Addition ❑Remodel ❑Repair DTI. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) IlAccessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: <br /> �/1jsf pole garage, no heat or plumbiny00fay'a <br /> Lv ' IM9ervl OvS waxer M Al Ir M <br /> 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 <br /> 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 <br /> 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, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 02/13/2023 5 7 3 01-- - <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br />