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13411DING 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 1. (E)PermitServices@everettwa.gov l (W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1516 RUCKER AVE PARCEL#: 00475430602600 <br /> cr EVERETT STATE WA ZIP 98201-2016 <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: Hiltons 1st&2nd, Blk 306 Lot No.:26&1/2 of 27 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Gregory Rielly <br /> OWNER MAILING ADDRESS: STREET 1516 RUCKER AVE clTv EVERETT STATE VV`^) <br /> A ZIP 98201 <br /> OWNER PHONE:425-359-7268 OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME: Karl Dropping Norsk Design Build <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):NORSKDB881 DR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6 / 3 Z <br /> CONTRACTOR ADDRESS: STREET14963 NE 95th St <br /> cir Redmond STATE WA ZIP 98052 <br /> CONTRACTOR PHONE:425-881-3539 CONTRACTOR EMAIL:karl.drOpping r1OrSkhOme.COm <br /> PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:425-776-7373 <br /> Albert Cohen, project architect CONTACT EMAIL: alcohendesign@gmail.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $224,600 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 residence <br /> PROPOSED USE OF BUILDING:Residence with AADU in basement <br /> HEAT SOURCE: ❑✓Gas ❑Electric DOtherMini-split for AADU <br /> BUILDING TYPE: ❑✓SFR ❑Townhouse ❑Duplex VADU ❑Multi Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑✓Addition RiRemodel ❑Repair ❑T.l. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:Demo carport, New 2 car garage addition and convert unfinished basement into AADU <br /> with one bedroom, new bath and kitchenette. Replace main floor kitchen partially in <br /> new addition, new bathroom and laundry, roof of garage addition to be WP deck, <br /> partially covered, Upper floornew WP deck on roof a kitchen addition and porch. <br /> Miscellaneous window and door changes/replacements. New concrete walks. <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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 8/10/2022 PET <br /> ZZO g <br /> - O <br /> (Revisedsl 4/21/2022) <br /> Owner/Authorized Agent Signature Date <br />