4330 COLBY AVE 2025-04-14 - Laserfiche WebLink

Nim Iry B•DING PERMIT APPLICATI 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 1(E)PermitServices@everettwa.gov (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4332 Colby Ave PARCEL#: 00407800301200 ciTy Everett STATE wa ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):CARLTON MANOR LLC LEGAL DESCRIPTION for new construction: Short Plat/subdivision. Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Tom Shin OWNER MAILING ADDRESS: STREET 2515 MUKILTEO SPEEDWAY aTy Mukilteo STATE wa zip 98275 OWNER PHONE:425-879-2076 OWNER EMAIL: sarahshin_usa@hotmail.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:Permits@rrspecialist.net PRIMARY CONTACT: ❑OWNER 71 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425 583 8062 Alesha Sti ckl es CONTACT EMAIL:alesha@rrspecialist.net BUILDING INFORMATION VALUATION OF WORK: $26700 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:Appartment PROPOSED USE OF BUILDING:No changes HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU EMulti-Family-#Units: ❑Commercial ❑'Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction EAddition ❑Remodel iRepair ❑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 13 helical piles to stabilize the foundation after settling 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 Alesha Stickler DigitasignedAlesha Date:lly2022.11.15by 14:1301 -O8'00stickles PERMIT# ' 7 0 G 2,D Owner/Authorized Agent Signature Date (Revised 4/21/2022) (/J