7130 HIGHLAND DR 2023-06-22 - Laserfiche WebLink

BAILDING PERMIT APPLICATI 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 7130 HIGHLAND DR PARCEL#: 00392800800500 cny 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: BEVERLY HILLS DIv 1 BLK 008 D-00 Lot No.: LOT 5 BLK 8 (attach copy of long legal description) ;/ CONTACT INFORMATION OWNER NAME:ADENM SIRAD&MOHAMAD KIFAH OWNER MAILING ADDRESS: STREET 7130 HIGHLAND DRIVE, CITY EVERETT STATE WA ZIP 98203 OWNER PHONE:206 973-9034 OWNER EMAIL: CONTRACTOR COMPANY NAME:Owner doing the work 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) Applecant CONTACT NAME: CONTACT PHONE:206 419-3709 Mazen Wallaia CONTACT EMAIL:mwallaia@yahoo.com BUILDING INFORMATION VALUATION OF WORK:$4000 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 Residence PROPOSED USE OF BUILDING:Family Adult Home HEAT SOURCE: ©Gas ❑Electric ❑Other BUILDING TYPE: ❑✓SFR ❑Townhouse ODuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial EAccessory Structure TYPE OF PROJECT(check all that apply): New Construction ❑Addition ©Remodel DRepair ❑T.1. ❑Change of Use ❑Modular ElPortable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Arr'sRory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ©Other:Adding ADA Ramp DESCRIPTION OF WORK:CONVERT EXISTING SINGLE-FAMILY HOME TO AFULT FAMYLY HOME. INSTALLING GRAB BARS IN THE EXISTING BATHROOMS AND ADA RAMP. 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/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 /� P,1L )G�E PERMIT# o e 9/ (i{/ �GCfi 8/15/2022 � Owner!AuthoriiAgent Signature Date (Revised 4/21/2022) v2—