1627 PUGET DR B 2025-08-14 - Laserfiche WebLink

ELI BI DING PERMIT APPLICATI I EVERETT CITY OF EVERETT PERMIT SERVICES 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1627 Puget Drive PARCEL#: 00393900501101 CITY Everett STATE wa ZIP 98208 SUITE/UNIT#: FLOOR#:basement 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:Matt Rolf OWNER MAILING ADDRESS: STREET 1627 Puget DR CITY Everett STATE wa ZIP 98208 OWNER PHONE:3607082050 OWNER EMAIL: therm06707©gmail.com CONTRACTOR COMPANY NAME:Dream Space LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):DREAMSL834QN CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57667 CONTRACTOR ADDRESS: STREE F5430 127th pl se CITY snohomish STATE wa ZIP 98296 CONTRACTOR PHONE:4254197940 CONTRACTOR EMAIL:ChriS.Groves@DreamSpaceLLC.com PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:42541 97940 Chris Groves CONTACT EMAIL:Chris.Groves©Dreamspacellc.com BUILDING INFORMATION VALUATION OF WORK: $50,000 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:Residential Home PROPOSED USE OF BUILDING:Remodel/Repair Basement to ADU 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:Remodel/put back together living space in Basement D MAR '' 0 9 20? CI T r' ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Wore 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 w,ith-tpe State Contractors Law 18.27 RCW and 296.200A WAC. 1... _ ._, City of Everett Official Use Only /� _ .- zoz3 P ITLAA, Oyirrler/Authorized Agent Sig' atufi re Date (Revised 4/21/2022)