7104 BEVERLY LN 2025-04-11 - Laserfiche WebLink

BUILDING PERMIT APPLICATII 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 l(E)everetteps@everettwa.gov l (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 7104 BEVERLY LN. PARCEL#: 00392000000501 clrr EVERETT STATE WA zip 98203 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:JAGNE JANKEH OWNER MAILING ADDRESS: STREET 6301 Elliott Way SE CITYEverett STATE WA zip 98203 OWNER PHONE:907 903-4344 OWNER EMAIL: JANKEHJAGNE@yahoo.com CONTRACTOR COMPANY NAME:Owner WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: El OWNER E CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: �/�� CONTACT PHONE:206 419-3709 Maze n Wa l l a i a CONTACT EMAIL:mwallaia©yahoo.com BUILDING INFORMATION VALUATION OF WORK:$30,000 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:Single Family Residence PROPOSED USE OF BUILDING:Single Family Residence HEAT SOURCE: ❑Gas ClElectric ❑Other BUILDING TYPE: ❑✓SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ZAddition ❑✓Remodel ❑✓Repair ETA. ❑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: n.+�io +inn the carport Into a IPavirlc� Remodel Existing Single Family Residence and r Feenr-, cr(Sewn=mod cstp_- Replacing exterior windows Converting the heat source from electric baseboard to a gas forced air. 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# l `7I20/2021 0 Owner/AuthorizAgent Signature Date (Revised 2/8/2021) 1/ Z