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B(DING PERMIT APPLICATIA <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2310 Virginia Ave PARCEL#: 00401649702700 <br /> cny Everett STATE WA zlh 98201 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Jeff and Sara Feinberg <br /> OWNER MAILING ADDRESS: STREET 2310 Virginia Ave <br /> Everett STATE WA ZIP 98201 <br /> OWNER PHONE:4254207808 OWNER EMAIL: Jeffeinberg©hotmail.com <br /> CONTRACTOR COMPANY NAME:Widen Construction LLC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):WIDENCL862LS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 56378 <br /> CONTRACTOR ADDRESS: sTREET27528 118th St Se <br /> CITY Monroe STATE WA ZIP 98272 <br /> CONTRACTOR PHONE:4253749409 CONTRACTOR EMAIL:Cmwiden@yahoo.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:4253749409 <br /> Caleb Widen CONTACT EMAIL:Cmwiden@yahoo.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $130,000 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:N/A <br /> PROPOSED USE OF BUILDING:Detached ADU <br /> HEAT SOURCE: ❑Gas ❑✓Electric Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex EAADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑✓New Construction ❑Addition ❑Remodel ❑Repair ETA. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:New Construction 880 sq ft Detached ADU located rear of lot , Existing 18x 20 garage <br /> will be removed prior. <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.1 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 /> PERMIT# <br /> 1 zi 14,/z3 <br /> Own r uthorized Agent Signature ®' Date (Revised 4/21/2022) <br />