2120 W MUKILTEO BLVD 2021-08-27 - Laserfiche WebLink

BUSING PERMIT APPLICATIOI 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)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2120 W Mukilteo Blvd PARCEL#: 00417000600200 cry Everett STATE Wa ZIP 98203 SUITE/UNIT#: FLOOR#: 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:Adis Zizak OWNER MAILING ADDRESS: STREET 1104 178th st SW _.¢ c,,. Lynnwood STATE Wa ZIP 98037 OWNER PHONE:425-268-2515 OWNER EMAIL: napandesign@gmail.com CONTRACTOR COMPANY NAME:PrOperyt Owner 1 1WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1 CONTRACTOR ADDRESS: STREET CITY STATE ZIP 3 CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-268-2515 i iAdis Zizak CONTACT EMAIL:napandesign@gmail.com i BUILDING INFORMATION VALUATION OF WORK: $100,000.00 ASSOCIATED LAND USE PROJECT#(if applicable): r (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:SFR --t. I PROPOSED USE OF BUILDING:SFR a HEAT SOURCE: ❑Gas ❑✓Electric ❑Other _1 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:Exterior paint, New siding, New heat pump (mini splits), Gravel, Pour concrete over I existing ext. steps, Plant Leyland Cypress Trees, Re-reef. New bathroom tile, replace vanities, toilets and sinks,replace 2 bath fans and kitchen hood.lnterior paint and trim, new kitchen cabinets / appliances and countertops. Replace flooring , int/ ext doors and railings. Replace existing can trim, swithces/ outlets and light fixtures. I4K00Fpi/r ilarda ✓ . W2 D2. -oo WZ1OZ'D 65 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 Suilding 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 t tate Contractors Law 107 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 3G) U.0 3 CO3 /2"/ t Owner/Authorized Agent Signature Date (Revised 2/8/2021) t/ ,%