6125 SYCAMORE PL 2024-06-13 - Laserfiche WebLink

E BOLDING PERMIT APPLICAT 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 I(E)everetteps@everettwa.gov I (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 6125 SYCAMORE PL PARCEL#: 00623500003600 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: HIGHLAND ESTATES Lot No.:LOT 36 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: LAPATSIN TIMOFEY G/SAVCHIK ANNA OWNER MAILING ADDRESS: STREET 6125 SYCAMORE PL CITY EVERETT STATE WA ZIP 98203 OWNER PHONE:425-737-2259 - OWNER EMAIL: timlapatsin@yahoo.com yahoo.com CONTRACTOR COMPANY NAME: ��1', 11r,1 WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY / STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR OTHER(Please Specify) CONTACT NAME:T I M LAPATS I N CONTACT PHONE:425-737-2259 l/1L-�- 77 j-L/35 CONTACT EMAIL:tjmlapatSln@yahoo.corn V BUILDING INFORMATION VALUATION OF W K:$ - ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include th prevailing fair arket value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:SINGLE FAMILY RESIDENCE PROPOSED USE OF BUILDING:SINGLE FAMILY RESIDENCE HEAT SOURCE: ❑Gas NElectric ❑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 DTI. ❑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:Change interior layout of non load bearing walls. New insulation, roof vents, drywall, finishes, appliances, and fixtures in living room and kitchen area. No change to bedrooms or garage. ACKNOWLEDGEMENT: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 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only rr, PERMITS r oc(L oc) ___(..,o Owner/Authorized Agent Signature Date (Revised 2/8/2021)