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BRING PERMIT APPLICATIJ <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 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 2330 Melvin Ave.' PARCEL#: 00544701401300 <br /> CITY Everett STATE Wa ZIP 98203 <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:Arturo and Elvia Nicasio <br /> OWNER MAILING ADDRESS: STREET 2330 Melvin Ave SE <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE:310-920-3501 OWNER EMAIL: elvianicasio61@gmail.com <br /> CONTRACTOR COMPANY NAME:Integrity Maintenance and Repair LLC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):INTEGMR782OT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 66683 <br /> CONTRACTOR ADDRESS: STREET 2215 117th Ave SE <br /> CITY Lake Stevens STATE Wa ZIP 98258 <br /> CONTRACTOR PHONE:425-232-6650 CONTRACTOR EMAIL:Jeremy@@integrityrepair.net <br /> PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-232-6650 <br /> Jeremy Maine CONTACT EMAIL:jeremy@integrityrepair.net <br /> BUILDING INFORMATION <br /> VALUATION OF ORK: $65,500 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall inclu e the prevailing fair market va e of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE F BUILDING:resi nce <br /> PROPOSED USE 0 G:residence <br /> HEAT SOURCE: ❑Gas ❑✓Electric ❑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 ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: Install new exterior furred walls with R-21 Insulation, replace 6x6 columns, and make <br /> minor adjustments to existing wall layout <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.I 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. .27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 12/11/2023 PERMIT# I VI <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />