5222 EAST DR 2023-06-16 - Laserfiche WebLink

BIDING PERMIT APPLICATION 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 5222 EAST DRIVE PARCEL#: 00471700001605 cm EVERETT STATE WA zip 98203 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:MOSES MATTHEW, ONOME EDITH OWNER MAILING ADDRESS: STREET 5222 EAST DRIVE ciTy EVERETT STATE WA zip 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME: 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 ❑✓ OTHER(Please Specify) ARCHITECT CONTACT NAME: CONTACT PHONE:4.25.377.8786 MARTIN RE I M ERS CONTACT EMAIL:MREIMERS@CONCEPTARCHITECTURE.COM BUILDING INFORMATION VALUATION OF WORK:$22,000 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:SFR PROPOSED USE OF BUILDING:AFH HEAT SOURCE: ❑Gas ✓❑Electric ❑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.l. ❑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:THE PROJECT WILL BE A GARAGE CONVERSION TO CREATE NEW LIVING SPACE TO USE FOR AN ADULT FAMILY HOME. THE NEW CONDITIONED SPACE WILL INCLUDE TWO BEDROOMS AND A STORAGE ROOM. 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 any 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 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 65 , Martin Reimers , ,, a� w 6 . 08/17/2021 ` Owner/Authorized Agent Signature Date (Revised 2/8/2021) //