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• • <br /> BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) .. .:. : . PROJECT.SITE INFORMATION,..;'. <br /> PROJECT SITE ADDRESS: STREET 1803 Hewitt Ave PARCEL#: 00439166500900 <br /> CITYEverett STATE WA ZIP 98201 <br /> SUITEIUNIT#: FLOOR#: 1,2 &3 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANTIBUSINESS NAME(if non-residential): Housing Hope <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> OWNER NAME: Housing Hope/Brian Richards <br /> OWNER MAILING ADDRESS: STREET 3315 Broadway <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425.347-6556 x.288 OWNER EMAIL: BrianRichards@housinghope.org <br /> CONTRACTOR COMPANY NAME: Belfor USA <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):BELFOUG990NJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 39176 <br /> CONTRACTOR ADDRESS: STREET 4320 S 131st Place, Suite 100 <br /> CITY <br /> Seattle, STATE WA ZIP 98168 <br /> CONTRACTOR PHONE: 206-632-0800 CONTRACTOR EMAIL: gary.mcconaghy@us.belfor.com <br /> PRIMARY CONTACT: ❑OWNER D ONTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME: Gary McConaghy CONTACT PHONE: 206-276-7335 <br /> CONTACT EMAIL: gaiy.mcconaghy@us.belfor.com <br /> us.belfor.com <br /> VALUATION OF WORK:$ 60,000 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: Low income residential <br /> PROPOSED USE OF BUILDING: Same <br /> HEAT SOURCE: ❑Gas DElectric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑ouplex ❑ADU CMulti-Family-#Units: 48 ['Commercial DAccessory Structure • <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel XIThepair Ebhange of Use <br /> C❑iiodular IL�ortable [De-roof IlIxterior Alteration Clank(above ground) [accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) DOther: <br /> DESCRIPTION OF WORK: Rebuild hallways to repair damage caused by water flooding the space.Work will <br /> be replacing like for like with the exception of the hallway flooring that will be <br /> replaced with lvp in lieu of the carpet.As noted by Everett Building Dept official <br /> we will be using 5/8"Type X GUM floor to ceiling where needed. <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 1 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 RCWand 296.200A WAG. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 10/20/23 13 2 3 D r I 0-7 <br /> Owner/Authorized Agent Si Date (Revised4/21/2022) <br />