6001 BROADWAY 2025-07-15 - Laserfiche WebLink

BIL ;DING PERMIT APPLICATI A CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL 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 6001 BROADWAY AVE PARCEL#: 28050500201400 Cm EVERETT STATE WA zIP 98203 SUITEIUNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANTBUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision; Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:TEFERA EYASU & BEYENE BILEN OWNER MAILING ADDRESS: STREET 6001 BROADWAY AVE CITY EVERETT STATE WA z,P 98203 OWNER PHONE:4259740287 1OWNER EMAIL: eyasutefera97@yahoo.com CONTRACTOR COMPANY NAME:T WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CRY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 0 OTHER(Please Specify) DESIGNER CONTACT NAME:J O EY CONTACT PHONE:2062407006 CONTACT EMAIL:joeydesignllc@gmail.com BUILDING INFORMATION VALUATION OF WORK:$15,000 1ASSOCIATED LAND USE PROJECT# if applicable): Valuations all include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actua y pad or not.) EXISTING USE OF BUILDING:SFR W/AFH j PROPOSED USE OF BUILDING:SFR W1 AFH HEAT SOURCE: ❑✓Gas ❑Electric ❑Other BUILDING TYPE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check aq 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: IR� OVE Convert the garage to three bedrooms with half bath and a 1 FEB 2 3 2024 CITY OF EVERETT Permit Services 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 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 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, and 1 comply with the State Contractors Law 18(----VW and 296.200A WAC. City of Everett Official Use Only " n � � PERMIT# Owner/Authorized Agent Signature N ate (Revised 4/21&022) (�`