2113 HOYT AVE 2025-05-23 - Laserfiche WebLink

NEM BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2113 HOYT AVE PARCEL#: 00439143400602 ciTv EVERETT STATE WA ZIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: EVERETT PI AT OFBLK4310-02-s1,OF LOT 6EALL Lot No.: 7 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:BLACK RICHARD A OWNER MAILING ADDRESS: STREET 2113 HOYT AVE CITY Everett STATE WA zip 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:WA STATE CONTRACTOR LICENSE#(REQUIRED):ROTDOD*768D9 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):( Rl rr p 3CA CONTRACTOR ADDRESS: sTREET523 GAYS DR CITY MARYSVILLE STATE WA zip 98271 CONTRACTOR PHONE:(425)971-2764 CONTRACTOR EMAIL:rotdr@icloud.com PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architectural Designer CONTACT NAME: CONTACT PHONE:(425)367-7773 Iri n a Zu bch i k CONTACT EMAIL:interiorardour@gmail.com ..,---/! BUILDING INFORMATION VALUATION OF WORK:$3,040. t i 9 Cp D ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevail' "fair market value of at 12bor,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 ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑✓Exterior Alteration LiTank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Expending and Repairing of existing deck ( nil\ r \-0, 10 . CE. " - -- \\i41 lUN`d 1. 2t11. , t) CITY OF EVER.ce Err permit 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.I am the owner,or 1 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 c4.i.r r^�ycu4cAL 06/13/2024 PERMIT# +/) — (') Owner/Authorized Agent Signature Date (Revised 4/21/2022) U