16 76TH ST SW 2025-08-20 - Laserfiche WebLink

BVILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASMNOTON 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 1(E)PerinitServices@everetlwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 16 76TH ST SW PARCEL#: 00393500000105 cnY EVERETT STATE WA Zip 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Platfsubdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:HABTYIMER MULU A OWNER MAILING ADDRESS: STREET 16 76TH ST SW CITY EVERETT STATE WA ZIP 98203 OWNER PHONE: 206-618-4174 OWNER EMAIL: CONTRACTOR COMPANY NAME:TBD 17VOrd WO f KsV LL-L WA STATE CONTRACTOR LICENSE#(REQUIRED):W0KRVh)t7 15 M Lt I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: Ci OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 240 7006 Joey CONTACT EMAIL: joeydesignLLC@gmaii.com BUILDING INFORMATION or VALUATION OF WORK:$10,000 1ASSOCIATED LAND USE PROJECT# if (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actua'ly p of.) EXISTING USE OF BUILDING:SFR PROPOSED USE OF BUILDING: HEAT SOURCE: R Gas ❑Electric ❑Other i BUILDING TYPE: ❑✓SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commerclal Accessory Structure TYPE OF PROJECT(check all(hat apply): El New Construction ❑Addilion x]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: o c!"E Rv CONVERT GARAGE TO HEATED SPACE. APR O 1 2024 CITY OF EVERETT Permit Seryinpq 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 Mo.,, 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 l am authorized by the owner of(his property to perform the work for which application is made, and I comply with the State Contractors La RCW and 296.200A WAC. 4/1/24 // City of Everett Official Use Only PERMIT# B2404 _h A Owner/Authorized Agent S gnature Date (Revised 412112022) UU