2314 LARLIN DR 2022-02-15 - Laserfiche WebLink

• • BUILDING PERMIT APPLICATION E u E R E T T CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINQTON 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 f(E)everetteps@everettwa.gov i(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: sTNEEr 2314 Ladin Dr. PARCEL#: • cm Everett STATE WA 98203 SUWTEJUNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential):SAMMY BIWOTT LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAMETAMRU TERFRA OWNER MAILING ADDRESS: amEET 4529 144TH PLACE SW cn r LYNNWOOD STATE WA 98087 OWNER PHONE:206-788-6250 'OWNER EMAIL:terfa05@yahoo.com CONTRACTOR COMPANY NAME:NA WA STATE CONTRACTOR LICENSE#(REQUIRED):NA 'CITY OF EVERETT BUSINESS LICENSE#IREQuIRED): CONTRACTOR ADDRESS: STREET Cm STATE zw CONTRACTOR PHONE: 'CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 1]OTHER(Please Specify)Tenant CONTACT NAME: CONTACT PHONE:425-503-2432 Sammy Biwott CONTACT EMAIL:ki rono.biWott p @gmafl.com BUILDING INFORMATION VALUATION OF WORK:$ VJ cry ASSOCIATED LAND USE PROJECT#(if applicable): (Vatualion shall Include the providing t market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not) EXISTING USE OF BUILDING:Residential PROPOSED USE OF BUILDING:Adult Family Home HEAT SOURCE: °Gas °Electric °Other • BUILDING TYPE: OSFR °Townhouse °Duplex OAOU °Multi-Family-#Units: °Commercial °Accessory Structure TYPE OF PROJECT(check all that apply): °New Construction °Addition °Remodel °Repair OT.I. °Change of Use ['Modular DPortable ORe-roof °Exterior Alteration °Tank(above ground) °Accessory Structure °Fence over 7ft high ORackStorage °Pool/Hot Tub Drank(above ground) °✓Other:Need building permHln order to schedule far wA90 Inspecrion DESCRIPTION OF WORK:No construction need to be done. ACKNOWLEDGEMENT:I have reviewed this application and confirm the Jeannetten contained herein Is hue and correct Worn done pursuant to this permit must comply with currant federal,slate,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.l am the owner,or t 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 RCWend 296.200A WAC. City of Evers*Official Use Only ji r t (: �,�N2/ PERMIT# 2-Io,Owner/Authorized Agent signature Date`(' J (Revised 2/8f2021)