5010 DOVER ST 2025-06-26 - Laserfiche WebLink

BUILDING PERMIT APPLICATION 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 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5010 Dover St PARCEL #: clTy Everett STATE WA z,p 98203 SUITE/UNIT #: FLOOR M 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:Graeme Eliott OWNER MAILING ADDRESS: STREET 5010 Dover St CITY Everett STATE WA zIP 98203 OWNER PHONE: 425-301-9260 1OWNER EMAIL: gelliott@spiritsoftware.biz CONTRACTOR COMPANY NAME:OWNER WA STATE CONTRACTOR LICENSE #(REQUIRED):OWNER CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): OWNER CONTRACTOR ADDRESS: STREET5010 Dover St cjTy Everett STATE WA z,P 98203 CONTRACTOR PHONE:4253019260 1CONTRACTOR EMAIL: gelllott@SplrltSoftware.biz PRIMARY CONTACT: 0 OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Graeme Elliott CONTACT PHONE: 425-301-9260 CONTACT EMAIL:gelliott@spiritsoftware.biz BUILDING INFORMATION VALUATION OF WORK: $115000 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: Family Residence PROPOSED USE OF BUILDING: Family Residence 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 ❑Tank (above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank (above ground) ❑Other: DESCRIPTION OF WORK:ADD 144SF TO EXPAND/REMODEL KITCHEN. DEMO FIREPLACE. Change contractor to owner occupier on permit number B2204-003 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 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 1 &27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT # Owner/Authorized Agent Signature Date (Revised 412112022)