2118 JEFFERSON PL 2024-10-25 - Laserfiche WebLink

LLT. BUILDING PERMIT APPLICATION 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)PermitServices@everettwa.gov I ((At)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2118 JEFFERSON PL, PARCEL#: 00512300000202 oily 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:SUSAN & DENNIS REITZ OWNER MAILING ADDRESS: STREET see project CITY STATE ZIP OWNER PHONE:425-355-8543 OWNER EMAIL: lee©verchi.com CONTRACTOR COMPANY NAME:R&R Foundation Specialist WA STATE CONTRACTOR LICENSE#(REQUIRED):RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 1611 E Marine View Dr CITY Everett STATE WA zip 98201 CONTRACTOR PHONE:425-760-5077 CONTRACTOR EMAIL:alesha©rrspecialist.net PRIMARY CONTACT: ❑OWNER ✓I CONTRACTOR Li OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-760-5077x107 Ales h a Sti ckl es CONTACT EMAIL:alesha©rrspecialist.net BUILDING INFORMATION VALUATION OF WORK: $20,510 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of at labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:SFR PROPOSED USE OF BUILDING:no change HEAT SOURCE: 1Gas 7Electric ❑Other BUILDING TYPE: I7SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel 7IRepair ❑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: Installation of 9 helical piles to stabilize the existing SFR to stabilize the foundation after settling. REcEllvE JUL 3 1 2023 CITY Of EVERETT ACKNOWLEDGEMENT I have reviewed this application and confirm the information contained herein is true and correct. Work done p�tfge e} omply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations mus 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 WAD. City of Everett Official Use Only '4 7/26/23 PERMIT# 3^^ �� - o i Owner/Authorized Agent Signature Date (Revised 4/21/2022) ✓,