2309 74TH ST SE 2025-08-22 - Laserfiche WebLink

%;I-DING PERMIT APPLICA-r 1N CITY OF EVERETT PERMIT SERVICES A► EVERETTSUBMITTAL 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)425-257-88101(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2309 74TH ST PARCEL#: 00398700200402 CITY EVERETT STATE WA vP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plattsubdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:DAGIM A. MENGISTU OWNER MAILING ADDRESS: STREET P.O. BOX 3305 CITY LYNNWOOD STATE WA ZIP 98046 OWNER PHONE:2068981028 1OWNER EMAIL: MDAGIMA@YAHOO.COM CONTRACTOR COMPANY NAME:TBD WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: MAY 0 1 202 1144 PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 121 OTHER(Please Specify) Designer ni: 'r CONTACT NAME:J O EY CONTACT PHONE:2062407006 Permit Services CONTACT EMAIL:joeydesignllc@gmail.com BUILDING INFORMATION VALUATION OF WORK:$72,800.00 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:SFR PROPOSED USE OF BUILDING:AFH HEAT SOURCE: ❑Gas BElectric ❑Other BUILDING TYPE: OSFR ❑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: PROPOSED INTERIOR ALTERATION TO MAKE ADULT FAMILY HOME 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 We/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.1 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 sa It l•�PERMIT# 6 I O9^ D03 Owner/Authorized Agent Signature Date (Revised 412112022)