8820 CORBIN DR 2022-08-11 - Laserfiche WebLink

* • im BUILDING PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 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 8820 Corbin Rd PARCEL#: 00541400001300 cITY Everett STATE WA ZIP 98204 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 copjr of long legal description) CONTACT INFORMATION OWNER NAME:Kasahun Meshesha OWNER MAILING ADDRESS: STREET 8820 Corbin Rd CITY Everett STATE WA ZIP 98204 OWNER PHONE:206-430-8252 OWNER EMAIL: CONTRACTOR COMPANY NAME: Owner WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR 0 OTHER(Please Specify) Owner's Agent CONTACT NAME: CONTACT PHONE: 425-345-2530 Dante Palmaffy CONTACT EMAIL: Dpalmaffy©aol.com BUILDING INFORMATION VALUATION OF WORK:$ 10000.00 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:AdUIt Family Home HEAT SOURCE: ❑Gas IlElectric ❑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:Concrete walk DESCRIPTION OF WORK:Remodel existing bathroom to accomodate converting the residence into an Adult Family home. Also the existing walkway to the front door is to be altered for accessibility. 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 Building Official before being a thorized 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 'th the State••. .ctors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only ' `�(-y_ozZ PERMIT# e ��0 _0 3 3 Ow er/Authorized Agent Signatur Date (Revised 2/8/2021)