6001 BROADWAY 2022-11-16 - Laserfiche WebLink

BIe..DING PERMIT APPLICATON 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 6001 BROADWAY. PARCEL#: 28050500201400 ciTY Everett STATE WA zip 98208 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:TEFERA EYASU & BEYENE BILEN OWNER MAILING ADDRESS: STREET 6001 BROADWAY CITY Everett STATE WA zip 98203 OWNER PHONE:4259740287 OWNER EMAIL: eyasutefera97@yahoo.com CONTRACTOR COMPANY NAME:OWNER TO MANAGE / BY 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 121 OTHER(Please Specify) Drafter CONTACT NAME:J o ey Perez CONTACT PHONE:2062407006 CONTACT EMAIL:joeydesignLLC@gmail.com BUILDING INFORMATION VALUATION OF WORK:$2,000.00 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:RESIDENCE PROPOSED USE OF BUILDING:RESIDENCE HEAT SOURCE: I✓IGas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ©Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): El New Construction ❑Addition I✓1Remodel ❑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: Change bedroom door ( 3 total) Add shower and toilet grab bars. 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 authorized under ny circumstance.lam 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 the State Contractors Law 8.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner/A orized Agent Signature Date (Revised 2/8/2021) !�