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E Blil.DING PERMIT APPLICAT•N <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION: (P)425-257-8810 I (E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1314 26TH ST PARCEL#: 00439161502802 <br /> ciy EVERETT STATE WA zip 98201-3406 <br /> SUITE/UNIT#: FLOOR#: 0 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Helping Hands Project Organization <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Mrs Vivian Obah <br /> OWNER MAILING ADDRESS: STREET 2408 Broadway Ave <br /> ci- EVERETT STATE WA ZIP 98201 <br /> OWNER PHONE: OWNER EMAIL: precision-designs@outl00k.COm <br /> CONTRACTOR COMPANY NAME:1ST CHOICE CONSTRUCTION INC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):1 STCHCC921 OE CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET410 Main St <br /> crry Algona STATE WA ZIP 98001 <br /> CONTRACTOR PHONE:253-569-4588 CONTRACTOR EMAIL:volyanskiyv@yahoo.com <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR E OTHER(Please Specify) GPD <br /> CONTACT NAME: CONTACT PHONE:(206)-787-9063 <br /> Alex Pi CONTACT EMAIL:precision-designs@outlook.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$330000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:OFFICE <br /> PROPOSED USE OF BUILDING:OFFICE <br /> HEAT SOURCE: ❑✓Gas ❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑✓Other: Interior remodel <br /> DESCRIPTION OF WORK: <br /> Unfinished basement remodel, conversion to office space <br /> 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 <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# ) l;r, <br /> 7-7 <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br /> l —�:=J <br />