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"•• <br /> BUILDING PERMIT APPLICATIM <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((E)everetteps@everettwa.gov((W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 5009 SEAHURST AVE PARCEL#: 29043600310000 <br /> Gay Everett STATE WA zip <br /> 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: SEC36-29-04 Lot No.: 2 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:HENOK YESHEWAERGET <br /> OWNER MAILING ADDRESS: STREET Same as above <br /> CITY STATE ZIP <br /> OWNER PHONE:206-753-9659 OWNER EMAIL: HENERY05@YAHOO.COM <br /> CONTRACTOR COMPANY NAME:Owner <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR i]OTHER(Please Specify) eMD Design Practice <br /> CONTACT NAME: CONTACT PHONE:206-775-1471 <br /> Ermias Hailu CONTACT EMAIL:ermias©emddesignpractice.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$35K ASSOCIATED LAND USE PROJECT It(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: SFR <br /> PROPOSED USE OF BUILDING:AFH <br /> HEAT SOURCE: OGas ❑Electric ilOther <br /> BUILDING TYPE: O✓SFR OTownhouse ODuplex DADU ❑Multi-Family-#Units: ❑Commercial DAccessory Structure <br /> TYPE OF PROJECT(check all that apply): :New Construction DAddition QRemodel ORepair []T.l. DChange of Use <br /> DModular [IPortable ORe-roof DExterior Alteration OTank(above ground) DAccessory Structure <br /> tot Tub OTank(above ground) DOther. <br /> ❑Fence over 7ft high ORackStorage ❑Pool H <br /> DESCRIPTION OF WORK:Interior work(The upper level only): For the purpose use of AFH. The work will consist <br /> of modifying the existing upper level by modifying the existing bathrooms to AFH <br /> standard and adding a new bedroom between the existing bedrooms. <br /> �� <br /> Exterior Work: New ramp for the main entry R MAR 1 4 2024 J} <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.We yptesFit Ekisi it' l.nTist(Comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Dewape rr ip t?a Qqf 4 j,siting from the <br /> Building Official before be ng authorized under any circumstance.I am the owner,or I am authorized by the owner of this props tie a rk fl4rr f application is made, <br /> and/comply with the 1-Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only <br /> /1,0ZO PERMIT# <br /> �/ /eV c <br /> Owner!, •J`Zed .=nt' ature Date (Revised 2/8/2021) <br />