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E BIDING PERMIT APPLICATEON <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 ail required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425.257.88101(E)everettepseteverettwa.gov j(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1504 50TH ST Ce PARCEL#: 00386300000500 <br /> my EVEREIT STATE WA zip 98203 <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: BAMER MC LAUGHLIN Lot No.: 5&6 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME111111111111111.1 Henok Yeshewaerget <br /> OWNER MAIUNG ADDRESS: smety 1504 SOTH ST <br /> CITY EVERETT STATE WA zip 98203 <br /> OWNER PHONE:206-753-9659 OWNER EMAIL: NENERY05@YAHOO.COM <br /> CONTRACTOR COMPANY NAME:OWNER <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: ethes-r <br /> cm' STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: E3 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) eMD DESIGN <br /> CONTACT NAME: CONTACT PHONE:206-775-1471 <br /> ERM1AS KOTU CONTACT EMAIL:ermias©emddesignpractice.com <br /> 8 , <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$521C ASSOCIATED LAND USE PROJECT*(if applicable): <br /> (Valuation etvg include the prevailing fatmarket value of all hem materials,and equipment needed to complete the work,whether actuaey;mkt or not) <br /> EXISTING USE OF BUILDING:AFH <br /> PROPOSED USE OF BUN-DING:AFH <br /> HEAT SOURCE: VaGas Electric DOther <br /> BUILDING TYPE: EISFR 0Townhouse DDuplex OADU 0Multi-Family-#Units: 0Commercial DAccessory Structure <br /> TYPE OF PROJECT(check all that apply): 1:iNew Construction DAddition lZlRernodel DRepair IZIT.I. DChange of Use <br /> DModuiar OPortable ORe-roof DExterior Alteration OTank(above ground) DAccessory Structure <br /> EiFence over 7ft high DRackStorage DPooi/Hot Tub DTank(above ground) DOther:Garage Conversion <br /> DESCRIPTION OF WORK: <br /> Interior work includes: Main level garage conversion to a livable space for sleeping <br /> area and to convert existing family room to office and storages. <br /> Exterior work includes: No exterior work <br /> ACKNOWLEDGEMENT I have reviewed this application and confinn the information contained herein is true and coned Work done pursuant to this permit must comply with <br /> current federal,state,end 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.lam the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and I coda*with rate Contractors Law19.27 RCW and 296,200A WAC. <br /> City of Everett Official Use Only <br /> .411k..daidorilff <br /> 4/1 irr'rt 10 PERMIT* <br /> bi,26(o -d G14- <br /> Ovine ,- t W <br /> hori -• ' •.rit Signature Dat (Revised 218/2021) <br /> i <br />