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D ECEUVEn <br /> vi <br /> IP" gm <br /> BIDDING PERMIT APPLICATIUI4 <br /> EVERETT SUBMITTAL INSTRUCTIONS:SeeCITY OF EVERETT PERMIT SERVICES MAY 2 8 2023 <br /> applicable submittal checklist for submittal requiremen a number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 erftref22rtF9 r}'tEk l5rop Box. <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov I(VV e�e�tvvia. oy%�grtr�jtt5 <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION "��'L V i° <br /> PROJECT SITE ADDRESS: STREET 555 Pilchuck Path, PARCEL#: 39660000501 <br /> cn Everett STATE WA ZIP 98201 <br /> SUITE/UNIT#: N/A FLOOR#: N/A ADDITIONAL LOCATION INFORMATION (if applicable): N/A <br /> TENANT/BUSINESS NAME(if non-residential):N/A <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: N/A Lot No.: N/A (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Austin Weaver <br /> OWNER MAILING ADDRESS: STREET 555 Pilchuck Path <br /> CITY Everett STATE Wa. ZIP 98201 <br /> OWNER PHONE:(425)207-6923 OWNER EMAIL: nfcwestl@comcast.net <br /> CONTRACTOR COMPANY NAME:N/A <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):N/A CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): N/A <br /> CONTRACTOR ADDRESS: STREET N/A <br /> CITY N/A STATE N/A ZIP N/A <br /> CONTRACTOR PHONE:N/A CONTRACTOR EMAIL:N/A <br /> PRIMARY CONTACT: I]OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:N/A <br /> N/A <br /> CONTACT EMAIL:N/A <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$5,300.00 ASSOCIATED LAND USE PROJECT#(if applicable):N/A <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:Single Family Residence <br /> PROPOSED USE OF BUILDING:It will continue to be used as a single family residence. <br /> HEAT SOURCE: ✓❑Gas ❑✓Electric ❑Other <br /> BUILDING TYPE: ❑✓SFR ❑Townhouse EDuplex ❑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) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:guild a new wrap around porch that begins four (4) feet from the Southwest corner of <br /> the house, continues North along the West side of the house, wraps around the <br /> Northwest corner of the house and ends 9 feet from the Northeast corner of the house. <br /> *This project has been revised to no longer include a roof. 8e, <br /> , n Sboar <br /> pJ2...„..yro,a...ce_,_ Thocev----- <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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT#B2302-046 <br /> .� '.f-,� QS' � 'Z.02_ 3 <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />