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BUILDING PERMIT APPLICATION. <br /> CITY Of EVERETT PERMIT SERVICES <br /> EVERETT SUBt,-,MAL INSTRUCTIONS:See app?canio st b rulit3l ctre:.klisl for submittal raqu'remsnts and number of copies roqulrad ter rruir,^, <br /> %hWiiNGTGN I`jej Crop ah cornp!eled appi!rat!on p1L*a5 required submittal do turidnts to 3200 Cedar.Sfrent 2nd Fta;r Inla:co Ornp Box. <br /> 66NTACT INFORMATION:(P)426 257.881d I E)evaretteps4evor0ttWa.ga4 1 tWJ clorettwa.gcviperrti La <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: sT•gEL, $909 Corbin Dive PARCEL#- C054140OM700 <br /> tsTr Everett sTk WA 892it4 <br /> SUITEJUNIT is FLOOR 9. AD DMONAL LOCATION INFbR?AATtON(d appilcabto)- <br /> TE.NANTIBUSiNESS'NAME(9 non-residential); <br /> LEGAL DESCRIPTION ra.new coostructwa.: Shal Fxmvsubd(yision. Lot No- (attach c vy n/,io*g <br /> CONTACT INFORMATION <br /> OWNER NAt.7;_:Tigist Kebede <br /> OWNER MAILING ADDRESS: srrr:,s 8909 Corbin Drive <br /> Everett s'.wTE WA 98204 <br /> OWNER PRONE:206-4320973 OWNER EMAIL: tigistl982@yahoo.com <br /> CONTRACTOR CO''PANY NAME.. L �� <br /> VGA E TE CONTRACTOR LICENSE-RECJIRED):LOMCCtNk-' F EVERETT BUSINESS LICENSE'I(REQUIRED)- <br /> CONTRACTOR ADDRESS: ?r— <br /> STArt ZIP <br /> c <br /> CONTRACTOR PHONE. LAWS �, CONTRACTOR EMAIL: <br /> PRIMARY COtiTACT: M O1VVNER C CONTRACTOR Eve OTHER(Please Specify) Designer <br /> CONTACT NAME. CONTACT PHONE: 206-6832395 <br /> Carmelo Laviste CONTACTEMAIL:cidesign.drafting@gmail.tom <br /> BUILDING INFORMATION <br /> VALUATION OF WO :S 8000.00 ASSOCIATED LAND USE PROJECT it of applicable): <br /> :1:r,.JA:4'G.ak.,,v:o Dec +ov?y y tar-az ] o.5 ecuvnannt Facatd fa=mow&Uw worKlltwlnor amauy IIad crnat) <br /> EXISTING USE OF suI1..DING. Single family residence <br /> PROPOSED USE OF BUILDING: Adult Family Home <br /> HEAT SOURCE: C�Gas `Elect �Otner <br /> BUILDING TYPE: ZSFR 17 Tawaousf: 0041ex DADU CMu;ti-Family-it Units: ❑Cbmmercial i]Axossory Structure <br /> TYPE OF PROJECT(check all that sppiy): EDNew Consru.4ion E—"Aamboa CRemodel ❑Repair OT.i. OChange of Use <br /> ;..;Mct uiar CParwle DAIe-roof CIExtenUr AlteraGan [Tank(above ground) ClAccessaryStructure <br /> '= <br /> nk{e ag;ound) ❑otherover (t ngh JRac�Sto,uga ❑Pto(rsiTub �7a <br /> DESCRIPTION OF WORK: <br /> Garage conversion into 2 bedrooms, bathroom and utility room, interior alterations, <br /> ramp and conversion of existing:SFR into an Adult-family home, <br /> Acwc t. .`_cs'iGCt.�YJY:J.Ao,.v rtr uAimr rt.s kvtwtian 81W tarJ`Jwm ma irita:mawn can!&r sd hereon is true wri Warm eano;.wmum ro tWs wov?rtuxt'com;.r r. <br /> Catf'�.";...::.-i' i..:-:k'D,ilttti 67CL.°tEW.TAa 1jfII174!F=f 4f FiAOrrT7il only 8L1r�OriZ45 vAArow��trLfd and fiA'lntwl�r;s-tht310r1G.:.LZJv1Dl JGS RTf/Sf Ia'Si b0 8tdlitT:I.Y6d ui tM2irsg tci:..ni th+3 <br /> C;em euRpraVe LW-der any era r°sxtimCa:I em ti er maer,or I am awn;rraad Ly 11:e uivrw of,174 p warty to paYam;0a.work far r:1 c':h aAY.'rar is madv. <br /> rrr:v f ca:.,, .. _, Sato Car?rarr(ss 4:eK 18.Y7 F?C'rtyrmd 29ti:2?�L'yAC. <br /> ;y c'C arf.a Crra w V5C,Cr--;,• <br /> P f_ <br /> Crv( eACd%*rl-ua As am Sai=ury r�„i4 t ©,rsod Lriti�Q2r} <br />