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[ ILDING PERMIT APPLICAT N <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <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 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1725 Hoyt Ave PARCEL#: 004380034601300 <br /> crrr Everett STATE WA z,P 98201 <br /> SUITEIUNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Piat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Roland Behee and Laura Cameron-Behee <br /> OWNER MAILING ADDRESS: STREET 1725 Hoyt Ave <br /> c,, Everett STATE WA zIP 98201 <br /> OWNER PHONE:425-330-0165 IOWNER EMAIL: ribehee@gmail.com <br /> CONTRACTOR COMPANY NAME:W-be-detefmined `S S <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED) 594WOF EVERETT BUSINESS LICENSE#(REQLl[RED)-3Ff SS 3 <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE <br /> ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-330-0165 <br /> Roland Behee CONTACT EMAIL:rlbehee@gmail.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$46,000 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:single family residence <br /> PROPOSED USE OF BUILDING:single family residence <br /> HEAT SOURCE: ❑✓Gas ❑✓Electric El Other <br /> BUILDING TYPE: ✓❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ✓❑Remodel ❑Repair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑PooVHot Tub ❑Tank(above ground) ❑Other <br /> DESCRIPTION OF WORK:Remodel existing bathroom and three bedrooms. Construct new bathroom from portion <br /> of existing bedroom. Restore original main floor room configurations, removing walls <br /> that were added in previous remodel work (1 970s-1 980s). <br /> ACKNOWLEDGEMENT:1 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.l am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> I/��i -::�)2 0 05 <br /> Owner/Authorized Agent Signature Dat¢ (Revised 4212022) <br /> �to�/I.✓�� ;���i�� <br />