4811 OCEAN AVE 2026-05-04 - Laserfiche WebLink

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 1 (E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4811 Ocean Ave PARCEL#: 00417400003301 CITY Everett STATE WA Zip 98023 Sul E/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: see attached Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Bill Dickinson OWNER MAILING ADDRESS: STREET 4811 Ocean Avenue CITY Everett STATE WA zIP 98023 OWNER PHONE:(425) 238-6854 OWNER EMAIL: bdickinson916@gmail.com CONTRACTOR COMPANY NAME:TBD WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect CONTACT NAME: CONTACT PHONE:(206) 794-2960 Mark J. VanVliet, Architect CONTACT EMAIL:mjvanvliet@comcast.net BUILDING INFORMATION VALUATION OF WORK: $30,000 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:Single Family Residence PROPOSED USE OF BUILDING:Single 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:Elevator DESCRIPTION OF WORK: Install two stop pneumatic elevator lift in existing residence. ACKNOWLEDGEMENT.'1 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 Digitally signedanVliet Mark J. VanVliet Date:2025.0430y13:59:38Mark J.V07'00' 04/30/25 PERMIT# Owner/Authorized Agent Signature Date (Revised 412112022)