4520 S 3RD AVE 2025-12-12 - Laserfiche WebLink

BUILDING PERMIT APPLICA) ON EVERETT CITY OF EVERETT PERMIT SERVICES 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)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4520 4Fdd AVTsS— S -2, hit 44W e PARCEL#: 00500400501000 CITY Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Minta Buse OWNER MAILING ADDRESS: STREET 4520 3rd AveS CITY Everett STATE WA ZIP 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME- �BB��(� WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑r OTHER(Please Specify) Owner's Agent CONTACT NAME: CONTACT PHONE:425-345-2530 Dante P {�t ly CONTACT EMAIL:Dpalmaffy@aol.com 001 BUILDING INFORMATION VALUATION OF WORK: Work complete d ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevails fair market value all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: e-family residence PROPOSED USE OF BUILDING:Single-family residence HEAT SOURCE: ❑Gas ❑✓Electric []Other BUILDING TYPE: ❑✓SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑✓Remodel ❑Repair ❑TJ. ❑Change of Use ❑Modular ❑Portable ❑Re-roof El Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:This remodel was completed without a permit and is under code enforcement and Hearing Examiner case #CE21-0373. 1t4A41 P2W6Cr 15 ib t�"E7 4ccx�p(�r OF t lAQ,5 pol "At" PL4c Zt F-u- tc_tm",s;Af 54r:R Y m 1 F(xTUe&,- Ljpr_>A-I�Dt /}-WU E-D CAP 0ATC->.FF,e Pt2Z-7 00A&, ACKNOWL EMENT.-I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current fed al.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 O icial before g authorize under any circumstance.1 am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, and 1 co ly with the to Contract s w 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# wne u rized Agent ignature Date (Revised 2/8/2021)