1412 E CASINO RD 2025-09-10 - Laserfiche WebLink

BL"' ;,DING PERMIT APPLICAT"N 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)425-257-8810 1(E)Permi(Services@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITEINFORMATION PROJECT SITE ADDRESS: STREET 1421 E CASINO RD PARCEL#: 00393600500603 CIn-, EVERETT STATE WA zl, 98203 SUITE/UNIT#: N/A FLOOR#: NIA ADDITIONAL LOCATION INFORMATION (if applicable):N/A TENANTIBUSINESS NAME(if non-residential):N/A LEGAL DESCRIPTION for new construction: Short Plat/subdivision: NOT SURE Lot No,:NOT SURE (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:JOSEPH NYAGUNDA& MUNDUI JUDY OWNER MAILING ADDRESS: STREET 1412 E CASINO RD clTy EVERETT STATE WA zIP 98203 OWNER PHONE:360 7633911 1OWNER EMAIL: WIKADESIGNS22@GMAIL,COM i CONTRACTOR COMPANY NAME:THE OWNER WILL DO THE WORK WA STATE CONTRACTOR LICENSE#(REQUIRED):N/A ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): NIA CONTRACTOR ADDRESS: STREETN/A CITY N/A STATE N/A zip NIA ( CONTRACTOR PHONE:NIA 1CONTRACTOR EMAIL:N/A I PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ✓❑OTHER(Please Specify) DESIGNER I I CONTACT NAME: CONTACT PHONE:2533980271 WI LLIAM ARAKA CONTACT EMAIL:WIKADESIGNS22@GMAIL.COM BUILDING INFORMATION VALUATION OF WORK: $60000 1ASSOCIATED LAND USE PROJECT#(if applicable):N/A (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the vrork,whether actually paid or not.) I EXISTING USE OF BUILDING:SFR PROPOSED USE OF BUILDING:FUTURE ADULT HOME ! HEAT SOURCE: ✓❑Gas ❑Electric ❑Other E BUILDING TYPE: ©SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure i TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ✓ZRemodel ❑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:CONVERT PART OF GARAGE TO BE 3 BEDROOMS AND STOVE CONSTRUCT A RAMP CONVERT TUB TO SHOWER IN ALL BATHROOMS t i I (E( t ACKNOWLEDGEMENT:t have reviewed this application and confirm the information contained herein is two 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 1 am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only W.A 08/14/2023 PERMIT# may, p r Owner/Authorized Agent Signature Date (Revised 412112022) i