9815 HOLLY DR 2025-04-15 - Laserfiche WebLink

BOLDING PERMIT APPLICAICN 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 1 (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 9815 Holly Dr. PARCEL#: See Attached CITY Everett STATE WA ZIP 98204 SUITE/UNIT#: See Attached FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: See Attached Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Holly 100 Condominiums Homeowners' Association c/o Della Clement- Impact Property Management (Property Manager) OWNER MAILING ADDRESS: STREET 9506 - 4th Street NE, Suite 101 01.0 CITY Lake Stevens STATE WA ZIP .98@32- OWNER PHONE:425-949-4554 OWNER EMAIL: holly100@impacthoa.com CONTRACTOR COMPANY NAME:Amor Restoration - Sarah Kennedy WA STATE CONTRACTOR LICENSE#(REQUIRED):AMORRRL809B4 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 63787 CONTRACTOR ADDRESS: STREET 18915 142nd Ave NE, Suite 140A WOODINVILLE, WA 98072 CITY Woodinville STATE WA ZIP 9 CONTRACTOR PHONE:206-669-9692 CONTRACTOR EMAIL:sarah @amorrestoration.com PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ]OTHER(Please Specify) Agent for Owner CONTACT NAME: CONTACT PHONE:206 281 7500 Chris Bacus Pacific Engineering Tech. CONTACT EMAIL:cbacus@ pacengtech.com BUILDING INFORMATION VALUATION OF WORK: $340,000 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 (Condominiums) PROPOSED USE OF BUILDING:No Change 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.l. ❑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: Fire Damage Repair to an existing condominium building 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 PERMIb- � \ \(�� 12/15/21 Owner/Authorized Agent Signature Date (Revised 2/8/2021) jJ,