5117 23RD AVE W 2018-01-02 MF Import

LI B!LDING PERMIT APPLICATI!N 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(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5117 23rd Ave W PARCEL#: 00669800000900 ciry Everett STATE WA zip 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):GRANADA SEAVIEW ESTATES NO.2 BLK 000 D-00-LOT 9 TGW AN EQUAL&UND INT IN TR A SUBJTO ESE CITY OF EVERETT,PUD 1&GEN TEL LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Chi Mei Yang OWNER MAILING ADDRESS: STREET 5117 23rd Ave W CITY Everett STATE WA zip 98203 OWNER PHONE:425-760-5077 OWNER EMAIL: cmyang68@gmail.com CONTRACTOR COMPANY NAME:R&R Foundation Specialist WA STATE CONTRACTOR LICENSE#(REQUIRED):RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): `,. 14 CONTRACTOR ADDRESS: STREET 1611 E Marine View Dr crrY Everett STATE WA zip 98201 CONTRACTOR PHONE:425-760-5077 CONTRACTOR EMAIL:alesha©rrspecialist.net PRIMARY CONTACT: 0 OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-760-5077 Ales h a Sti ckl es CONTACT EMAIL:alesha@rrspecialist.net BUILDING INFORMATION VALUATION OF WORK: $17,400.00 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:SFR PROPOSED USE OF BUILDING:no change HEAT SOURCE: ❑Gas ❑Electric ❑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: Installation of 8 helicals 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 it(h�th Sta -Contractors Law 18.27 RCW and 296.200A WAC. WO I, City of Everett Official Use Only PERMIT# 3/23/23 0- ' - r l Owner/Authorized Agent Signature Date (Revised 4/21/2022)