7711 BEVERLY BLVD B KIDI ADULT FAMILY HOME 2025-03-25

BUI- ING PERMIT APPLICATIC 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)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 7711-B Beverly Blvd PARCEL#: 00393900200402 cm, 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: SE Beverly Park Plat BLK 002 Lot No.:4 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Mathewos Haile and Kidist Asfaw OWNER MAILING ADDRESS: STREET 7711-B Beverly Blvd CITY Everett STATE WA ZIP 98203 OWNER PHONE:(206) 376-0415 OWNER EMAIL: CONTRACTOR COMPANY NAME: V ED 16119 amylDor\am JF\c v► & )jW O 'I WA STATE CONTRACTOR LICENSE#(REQUIRED):UNKNOWN CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET KI N u OG R S 0 Z R 1- CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect CONTACT NAME: CONTACT PHONE:(425) 377-8786 Martin Reimers CONTACT EMAIL:mreimers@conceptarchitecture.com UILDING INFORMATION VALUATION OF ORK:$ 2 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include prevailing fair market value of all labor,materials equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Singre residence PROPOSED USE OF BUILDING:AdUIt family home 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:THE PROJECT WILL CONSIST OF CONVERTING THE LOWER LEVEL OF AN EXISTING SINGLE FAMILY RESIDENCE TO AN ADULT FAMILY HOME. INCLUDED AS A PART OF THE NEW AFH WILL BE CONVERTING THE GARAGE INTO LIVING SPACE. 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 PERM��` ��,, t o 3 Martin Reimers Owner/Authorized Agent Signature Date (Revised 2/8/2021)