3409 FEDERAL AVE 2023-12-07 - Laserfiche WebLink

Elm BoDING PERMIT APPLICAIWN 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 1 (E)everetteps@everettwa.gov l(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 3409 Federal Ave PARCEL#: 00437582800400 Cm Everett STATE WA zip 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Broadview Holdings LLC LEGAL DESCRIPTION for new construction: Short Plat/subdivision: EVERETT DIV H PLAT OF BLK 828 D-oo Lot No.: LOTS 4&5 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Broadview Holdings LLC OWNER MAILING ADDRESS: STREET 300 NW 110th St CITY Seattle STATE WA ZIP 98177 OWNER PHONE:360-991-8659 OWNER EMAIL: broadviewholding@gmail.com CONTRACTOR COMPANY NAME:Express Innovations LLC WA STATE CONTRACTOR LICENSE#(REQUIRED): 604 744 469 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): Pending CONTRACTOR ADDRESS: STREET 6229 28TH ST NE CITY Tacoma STATE WA ZIP 98422 CONTRACTOR PHONE:2538808176 CONTRACTOR EMAIL:expressrpm@OutlOok.com PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:2538808176 Raul Ponce CONTACT EMAIL:expressrpm@outlook.com BUILDING INFORMATION VALUATION OF WORK: $120,000 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:Residential - SFH PROPOSED USE OF BUILDING:Residential - SFH HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: L1SFR ❑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: Remodel of existing structure mostly cosmetic including new floors, bathroom fixtures, and paint. Will add new bedroom / bathroom in basement and new lighting throughout the house and replace roof. 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 Contract Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only (� , J' Paul Sobolewski aye 202,05 aosassa oiook 9/23/2021 PERMI L �/ Owner/Authorized Agent Signatu Date (Revised 2/8/2021) It;