3425 BELL AVE 2023-06-20 - Laserfiche WebLink

1111111111 • B LDING 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)j PROJECT SITE INFORMATION PROJECT SIITE ADDRESS: s REET 3425 BeII/eve PARCEL#: 00561900101300 CITY Everett STATE WA ZIP 98201 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:James&Yukako Hernandez OWNER MAILING ADDRESS: STREET 3427 Bell Ave CITY Everett STATE WA zip 98201 OWNER PHONE:425-231-0435 OWNER EMAIL: hernandezcapital.11c@gmail.com CONTRACTOR COMPANY NAME:Owner built WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Authorized Agent CONTACT NAME: CONTACT PHONE:210-897-3694 Robert Smith Mac Donald CONTACT EMAIL: robmac50.rs@gmail.corn BUILDING INFORMATION VALUATION OF WORK: $ 50,000 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: Single Family Unit(Non Conforming) PROPOSED USE OF BUILDING: Single Family Unit 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.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: C LI IT 8-06 . -INTERIOR WORK ON 2ND/HOUSING UNIT.TWO(2)NEW BEDROOMS&EGRESS WINDOWS, NEW KITCHENETTE, UPGRADE OF LAUNDRY&BATHROOM AREAS. (SEE PLANS FOR WORK CALRIFICATION) 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.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 with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT#,/ �4Qizt `7�'hi a 09/09/2021 7 a 'C l --_. Owner/Authorized Agent Signature Date (Revised 2/8/2021)