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BIDING PERMIT APPLICAT•N <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION: (P)425.257.8810 I (E)everetteps@everettwa.gov I (W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1820 Oakes Ave PARCEL#: 00437936602200 <br /> cm( Everett STATE WA ZIP 98201 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME (if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Jonathan Tuck and Lisa Bleil <br /> OWNER MAILING ADDRESS: STREET PO BOX 312 <br /> CITY Mukilteo STATE WA zip 98275 <br /> OWNER PHONE:425-777-0356 OWNER EMAIL: pete@nordicforthehome.com <br /> CONTRACTOR COMPANY NAME:Owner <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):N/A CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): N/A <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑✓ OTHER (Please Specify) Engineer <br /> CONTACT NAME: CONTACT PHONE:425-891-51 1 1 <br /> Ken Nguyen CONTACT EMAIL:housedesign4u@outlook.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $20000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:Single Family Residential <br /> PROPOSED USE OF BUILDING:Single Family Residential <br /> HEAT SOURCE: ❑Gas ❑Electric ❑Other <br /> BUILDING TYPE: 7SFR ❑Townhouse ❑Duplex L1ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT (check all that apply): ❑New Construction ❑Addition ❑✓Remodel ❑Repair ❑T.I. CChange of Use <br /> C Modular ❑Portable ❑Re-roof (Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> [—Fence over 7ft high ❑RackStorage CPool/Hot Tub ❑Tank(above ground) LOther: <br /> DESCRIPTION OF WORK:Legalize as built interior ceiling and roof support cut-out area. Remove existing stair, <br /> attic bedroom, and seal stair access. Provide attic insulation. <br /> 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 <br /> 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 <br /> 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. <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Zew 1 :ueyet 3/4/2022 PE #-12-0 O f <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br /> 2- <br />