8411 E XAVIER WAY 2023-10-16 - Laserfiche WebLink

mil BUILDING PERMIT APPLICATION 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 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) 7:PROJECT SITE INFORMATION 'PROJECT SITE ADDRESS: STREET 8411 E Xavier Way PARCEL#: 061-00394200000101 crry Everett STATE WA ZIP 98208 SUITE/UNIT#: FLOOR#:2 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) .P CONTACT"INFORMATION OWNER NAME:Kevin Dong OWNER MAILING ADDRESS: STREET 7188 169TH AVE SE cln. Bellevue STATE WA ZIP 98006 OWNER PHONE:425-598-8888 OWNER EMAIL: kedo1009@gmail.com CONTRACTOR COMPANY NAME: 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 ❑✓ OTHER(Please Specify) Owner assisiant CONTACT NAME: CONTACT PHONE:206_227-3768 Ray Du CONTACT EMAIL:ray@evergrandholding.com ,- BUILDING:INFORMATION VALUATION OF WORK:$N/A Previous owner did the work ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:1 PROPOSED USE OF BUILDING:1 HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: ❑✓SFR ETownhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all 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:Basement finish DESCRIPTION OF WO , • e' ... iNI,AD S..k—A kit/Lb Ci?,tJC-- etil&-t..Cret-- Za./-00(‘‘— EAtiC_, ) %A1P-'‘C,20. - r v\e.„ k n ACKNOWLEDGEMENT: • I have reviewed this a lication and confirm the information contained herein is true and correct. Work done pursuant to th 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 au orized 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 th rk for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. CCity�ofEvEverett Official UseOnly J7 4'/' q /2" PEsT� J�-0V Owner/Authori Agent Signature Date (Revised 2 2 W190 — IC)(2—_.