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BUILDING PERMIT APPLICATION <br /> CITY OF EVERE'TT PERMIT SERVICES <br /> E V E R E T T 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2612 581h St SW PARCEL#: 00813500001600 <br /> city Everett STATE WA zap 98203 <br /> SUITEIUNIT#: FLOOR#: 1 ADDITIONAL LOCATION INFORMATION(if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivislon: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Gabe&Joy Cobo <br /> OWNER MAILING ADDRESS: STREET 2612 58th St SW <br /> cnv Everett STATE WA vP 98203 <br /> OWNER PHONE:714-225-7113 OWNER EMAIL: jgecobo@gmail.com <br /> CONTRACTOR COMPANY NAME:JL Remodeling Inc. <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):CCJLREMI"981 JD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62458 <br /> CONTRACTOR ADDRESS: STREET 19504 24th Ave W. <br /> crrr Lynnwood STATE <br /> WA Z1P 98036 <br /> CONTRACTOR PHONE:425-493-4742 CONTRACTOR EMAIL:ryyan@ jlremodeling.com <br /> PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-422-7163 <br /> Ryan Sims CONTACT EMAIL:ryan@jlremodeling.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$67,800 ASSOCIATED LAND USE PROJECT# if applicable), <br /> (valuatlon shall Include the prevailing fair markel value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:Residence <br /> PROPOSED USE OF BUILDING:Residence <br /> HEAT SOURCE: ©Gas {]Electric ❑Other <br /> BUILDING TYPE: ©SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-1F Unns: ❑commercial (]Accessory Structure <br /> TYPE OF PROJECT(check all that apply): El New Construction ❑Addition ©Remodel ❑Repair ❑T.I. ❑Change of Use <br /> ❑Modular []Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: <br /> Drywall only permit. No structural changes to space. Demo primary suite flooring, <br /> cabinet, countertop, sinks, mirror, vanity light, tub, tub filler, tub deck, shower, shower <br /> valve and trim, shower glass, toilet, base molding, can trims, fan and bath set. Prep <br /> space and apply appropriate protection to all surrounding areas. Replace bathtub, <br /> install new cabinets/countertops, and build new shower surround with a glass <br /> enclosure. <br /> ACKNOWLEDGEMENT.,f 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 authorized under any circumstance.I em the owner,or t am authorized by the owner of this property to perform the work for which applloation is made, <br /> and I comp! with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> / q_ PERMIT# <br /> Owner/Authorized Agent Slgnatu're I Date (Revised 4/21/2022) <br /> -- t <br /> r_ 1 <br />