9227 4TH AVE W 2024-08-12 - Laserfiche WebLink

BU- "-)ING PERMIT APPLICATIeV 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 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 9227 4th AVE W PARCEL#: 00480200101801 crry Everett STATE WA zip 98204 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:AdiS Zizak OWNER MAILING ADDRESS: STREET 1104 178th st SW CITY Lynnwood STATE WA ZIP 98037 OWNER PHONE:425-268-25515 OWNER EMAIL: napandesign@gmail.com CONTRACTOR COMPANY NAME:Napa Homes LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):NAPAHHL798JM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 64947 CONTRACTOR ADDRESS: STREET1104 178th ST SW CITY Lynnwood STATE WA zip 98037 CONTRACTOR PHONE:425-256-2515 CONTRACTOR EMAIL:Napandesign@gmail.com PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-268-2515 Adis Zizak CONTACT EMAIL:NapandeSlgn@gmall.com BUILDING INFORMATION VALUATION OF WORK: $475,000 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:SFR PROPOSED USE OF BUILDING:IDUplex HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: ❑SFR ❑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:This project proposes to remove existing single family house structure, detached garage, existing driveway and construct one new duplex structure and driveway access serving both units. 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 Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# i/ 3V 2 Z 62_3 D 6 - OD Owner/Authorized Age ignature Date (Revised 4/21/2022)