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BUILDING PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETT <br />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 1 (E) everetteps@everettwa.gov I (W) everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: STREET 416 Veralene Way SW PARCEL #: 00708000006700 <br />CITY Everett STATE WA Zip 98203 <br />SUITE/UNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION (if applicable): <br />TENANT/BUSINESS NAME (if non-residential): <br />LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Patrick and Andrea Banocy <br />OWNER MAILING ADDRESS: STREET 416 Veralene Way SW <br />CITY Everett STATE WA Zip 98203 <br />OWNER PHONE: 814-404-7388 <br />OWNER EMAIL: andrea.banocy@gmail.com <br />CONTRACTOR COMPANY NAME: Threshold Renovations LLC CA <br />WA STATE CONTRACTOR LICENSE #(REQUIRED): THRESRL790KE <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED):-, <br />CONTRACTOR ADDRESS: STREET 14475 156th Ave NE <br />aTy Woodinville STATE WA Zip 98072 <br />CONTRACTOR PHONE:425.770.0950 <br />CONTRACTOR EMAIL: John@thresholdreno.com <br />PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />John M e i kl a <br />CONTACT PHONE:425.770.0950 <br />CONTACT EMAIL: John@thresholdreno.com <br />BUILDING INFORMATION <br />VALUATION OF WORK: $ $60,000 <br />ASSOCIATED LAND USE PROJECT # if applicable): <br />(Valuation shall include the prevailing fair market value of all labor, materials, and equipment needed to complete the work, whether actually paid or not.) <br />EXISTING USE OF BUILDING: Residential SFR <br />PROPOSED USE OF BUILDING: Same <br />HEAT SOURCE: ❑✓ Gas ❑Electric ❑Other <br />BUILDING TYPE: ZSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure <br />TYPE OF PROJECT (check all that apply) : []New Construction ❑Addition ©Remodel ❑Repair ❑T.I. ❑Change of Use <br />❑Modular ❑Portable ❑Re -roof ❑Exterior Alteration ❑Tank (above ground) MAccessory Structure <br />LiFence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank (above ground) ❑Other: <br />DESCRIPTION OF WORK: <br />Cosmetic interior remodel. , fteer4ig minor relocation of some <br />electrical/plumbing as required for new cabinet/appliance locations. Removal of one <br />non load bearing interior partition wall (home has a full -span engineered truss roof <br />system, all interior walls are non load bearing) and addition of a new, non load bearing <br />small interior partition wall. <br />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 <br />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 <br />Building Official before being authorizer) 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, <br />and 1 comply with the State Contractors Law 18.27RCWand 296.200A WAC. <br />07/08/2021 <br />Owner A thorized Agent Signature <br />Date <br />City of Everett Official Use Only <br />PERMIT# <br />(Revised 216/2021) <br />