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B•.DING PERMIT APPLICATON <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETTSUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements arD umber of copies required for rwi , <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 ar Street 2nd Floor Intake Drop x. <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov evereARgoldiert 21 <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1030 Ttereve Drive,Everett,WA PARCEL#: 003928006q1 Y OF EVERETT <br /> rermit Services <br /> CITY Everett STATE WA ZIP 98201 <br /> SUITE/UNIT#: All Units FLOOR#: 1,2,and 3 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Marie Anne Apartments <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Beverly Hills Div.1 Blk 006 Lot No.: 1&2 Block 6 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:GJJ Williams Investments LLC <br /> OWNER MAILING ADDRESS: STREET 2517 Colby Avenue <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE:425-355-0353 OWNER EMAIL: ryan@williamsinvest.com <br /> CONTRACTOR COMPANY NAME:JKW General, LLC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):JKWGEGL929O5 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 55013 <br /> CONTRACTOR ADDRESS: STREET 2517 Colby Ave <br /> CITY Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:(425) 750 7926 CONTRACTOR EMAIL:ryan@williamsinvest.com <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Doug Hofius,Dykeman Architects <br /> CONTACT NAME: CONTACT PHONE:206 795 2192 <br /> Doug Hofius CONTACT EMAIL:dough@dykeman.net <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $60,000 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:Multi-family apartments <br /> PROPOSED USE OF BUILDING:Multi-family apartments <br /> HEAT SOURCE: ❑Gas ❑✓Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑✓Multi Family-#Units:33 ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑✓Remodel ❑Repair ❑T.I. ❑Change of Use <br /> El Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other:Replace existing 6'Fence at property line. <br /> DESCRIPTION OF We - • Provide washers :nd dryers at residential units. Provide repairs to any walls affected <br /> •escrl.ed irnenclose. pans <br /> ep ace existing 6' fence at south and west property lines adjacent to neighboring <br /> ro erties. <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 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 <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 WAC. <br /> City of Everett Official Use Only <br /> w 4// g61 t' cM -OCC, C <br /> Owner/Author Agent nature Date (Revised 4/21/2022) <br />