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LAND USE PERMIT APPLICATION <br /> CITY OF EVERETT PLANNING DIVISION <br /> EVERETT INSTRUCTIONS: Complete form, sign, and date. <br /> WASHI NGTON See applicable land use application packet for all required checklist items. <br /> CONTACT INFORMATION <br /> APPLICANT JOSE PEREZ <br /> ADDRESS #12491 3102 Hoyt Ave. <br /> CITY Everett STATE WA ZIP 98201 <br /> PHONE 206.240.7006 EMAIL joeydesignllc@gmail.com <br /> OWNER ALI SEID MOHAMMED <br /> ADDRESS 4041 169th Ave SE <br /> CITY Bellevue STATE WA ZIP 98008 <br /> PHONE (206) 261-7592 EMAIL Seidali99@gmail.com <br /> PRIMARY CONTACT:El APPLICANT ❑ OWNER ❑ OTHER, PLEASE SPECIFY BELOW <br /> NAME JOEY PEREZ <br /> PHONE 2062407006 EMAIL joeydesignllc@gmail.com <br /> PROJECT SITE INFORMATION <br /> ADDRESS 706 88th st se Everett <br /> PARCEL NO(S) 28051800206200 <br /> PROJECT INFORMATION <br /> PROJECT NAME PROPOSED ADULT FAMILY HOME <br /> PROJECT PROPOSED ADDITION OF UPPER FLOOR AND <br /> DESCRIPTION <br /> CONVERSION OF GARAGE INTO BEDROOMS AND OFFICE WITH INTERIOR ALTERATIONS TO <br /> CREATE AN ADULT FAMILY HOME <br /> VALUATION 300,000 <br /> Authorization: I am the owner or am authorized by the owner to sign and submit this application. I certify under penalty <br /> of perjury of the laws of the State of Washington that the information on this application and all information submitted <br /> herewith is true, complete, and correct. <br /> SIGNATURE DATE <br /> PRINT NAME <br /> CITY, STATE <br /> 2930 Wetmore Ave, Ste 8-A © 425.257.8731 O planning@everettwa.gov <br /> Everett, WA 98201 425.257.8742 fax everettwa.gov <br /> I Inn ATCn 7n1l <br /> Doc ID: 54fb363db4bca2efd650d03825a3c577b96f8f24 <br />