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MIS <br /> SIA <br /> BDING PERMIT APPLICATI <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 9030 4th PL SE PARCEL#: 00402600001400 <br /> c. Everett STATE WA zip 98208 <br /> SUITE/UNIT#: FLOOR#:1 ADDITIONAL LOCATION INFORMATION(if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):N/A <br /> LEGAL DESCRIPTION for new construction: Short PlaVsubdivision: CASCADE UT vow IRS OW re ELK Lot No.:14 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Nhi Pham <br /> OWNER MAILING ADDRESS: stra i 11229 32nd Drive SE <br /> cnY Everett STATE Wa. a, 98208 <br /> OWNER PHONE:425-530-6908 OWNER EMAIL: Nhi2868@yahoo.Com <br /> CONTRACTOR COMPANY NAME:TBD <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE DP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: 0 OWNER EONTRACTOR I J1THER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-530-6908 <br /> Nhi Pham CONTACT EMAIL:Nhi2868@yahoo.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$40,000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevaing far market value of a labor,=fermis,and equipment needed to complete the work,whether actual,/paid or not) <br /> EXISTING USE OF BUILDING:SFR <br /> PROPOSED USE OF BUILDING:SFR <br /> HEAT SOURCE: .as lectric r <br /> BUILDING TYPE:✓ FR ownhouse • a DU ■ utti-Family-#Units: Flommenciat ccessory Structure <br /> TYPE OF PROJECT(check all that apply): ew Construction ®ddition tIemodel {1epair u.t. Uhange of Use <br /> nodular I}ortable e-roof erior Alteration ank(above ground) ccessory Structure <br /> ence over 7ft high ackStorage ool/Hot Tub ank(above ground) er. <br /> DESCRIPTION OF WORK:Updating to existing house with garage addition. <br /> ACKNOWLEDGEMENT:I have reviewed this application and cahfam the information contained herein is true and correct.Work done pursuant to this penrat must comply with <br /> current feclerai 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 tam the owjet or am aUthariaX1 by the cavner of this property to perform the work for which eppbeerien is <br /> and I comply with the to Con Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT <br /> 03/09/2021 bW e0 2 —tJ6 7 <br /> Owned �,�- Date (Revised2JS/2O2t) _ <br />