9512 HOLLY DR 2023-06-08 - Laserfiche WebLink

BUILDING PERMIT APPLICATION J •�w CITY OF EVERETT PERMIT SERVICES Y 1 SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, wAsattrro7oN 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) PermitServices@everettwa.gov I (W) everettwa.govlpermits VALUATION OF WORK: $ 400 (Valuation shall include the prevailing fair market value of all labor, mateaals, EXISTING USE OF BUILDING: SINGLE FAMILY HOME PROPOSED USE OF BUILDING: ADULT FAMILY HOME T SOURCE: ❑Gas DElectric ❑Other ASSOCIATED LAND USE PROJECT # (if applicab ament needed to complete the work, whether actually paid or not.) IUILDING TYPE: I-ZSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial YPE OF PROJECT (check all that apply) : ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. LJModular QPortabie ❑Re -root ❑Exterior Alteration ❑Tank (above ground) LJAccessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank (above ground) ❑Other. PTION OF WORK: DEMOLITION OF DRYWALL ELECTRIC AND PLUMBING FlAccessory Structure ❑Change of Use TO ENABLE INSPECTOR INSPECT THE FRAMING, ON PREVIOUS PERMIT 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 Budding Official before being authorized 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. owner/Author4@ Agalff! 06/23/2022 1 PERMIT # Date City of Everett Official Use Only