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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 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 535 View Ridge Drive PARCEL#: 004647 000 062 01 <br /> CITY Everett STATE WA Zlp 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: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:J & S Development LLC <br /> OWNER MAILING ADDRESS: STREET 22621 57th Ave SE <br /> clTv Bothell STATE WA ZIP 98021 <br /> OWNER PHONE: 425-870-8922 OWNER EMAIL: bstrootman@msn.com <br /> CONTRACTOR COMPANY NAME:J & S Development LLC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):JSDEVSD878JN CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET22621 57th Ave SE <br /> clTv Bothell STATE WA 98021 <br /> Z.IP <br /> CONTRACTOR PHONE: 425-870-8922 CONTRACTOR EMAIL:bstrootman@msn.com <br /> PRIMARY CONTACT: ❑OWNER (1,CONTRACTOR ✓J OTHER(Please Specify) Civil Eng <br /> CONTACT NAME: CONTACT PHONE:425-773-9567 <br /> Bob Nehring, PE Sound Design Eng CONTACT EMAIL:bob.sdeng@gmail.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $600,000 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: Vacant Lot <br /> PROPOSED USE OF BUILDING:Build SFR model 4335 <br /> HEAT SOURCE: L_IGas ❑Electric ❑Other <br /> BUILDING TYPE: ©SFR [-]Townhouse ❑Duplex JADU ❑Multi-Family-#Units: L1Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(Check all that apply): C'New Construction ❑Addition L_'Remodel LRepair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration LjTank(above ground) L_IAccessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: <br /> Build new house model 4335 with Driveway and utilities <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 rederaf,state,and focal law. The granting of a permit only autnonzes 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WA <br /> City of Everett Official Use Only <br /> 6/26/23 PERMIT# <br /> ownertAbthdrized Agent SJignature Date (Revised 412112022) <br />