226 80TH PL SW 2025-08-20 - Laserfiche WebLink

RIM BU DING PERMIT APPLICATu .©[Q V E 1 EVERETT SUBMITTAL INSTRUCTIONS:See CITY OF EVERETT PERMIT SERVICES applicable submittal checklist for submittal re uir is and��mb rQQf re uir f)r review, WASHINGTON then drop off completed application plus all required submittal documents 00 Cedar St�eet 2Vor In Box. CONTACT INFORMATION:(P)425-257-8810 i(E)PermitServices@everettwa.ypyj.L )Pxv(rettVgovv/pe TT (Blue or Black Ink Only Please) PROJECT SITE INFORMATION l POfmlt ECn/Ik,CS PROJECT SITE ADDRESS: STREET 226 80th PI SW PARCEL#: cmr Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#:1 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: Elena LitovchenkoLOST" MayLL.P C-Oe)&teL-71 NJ � OWNER MAILING ADDRESS: sTREEr 5506 Glenwood Ave CITY Everett STATE WA zip 98203 OWNER PHONE:425-344-6048 OWNER EMAIL: elenalitov@yahoo.com CONTRACTOR COMPANY NAME: WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: l OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-34.4.-6048 Elena Litovchenko CONTACT EMAIL:elenalitov@yahoo.com BUILDING INFORMATION VALUATION OF WORK:$7,800 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of ail labor,materials,and equipment needed to complete the work,whether actually paid or not.) .EXISTING USE OF BUILDING:Residential PROPOSED USE OF BUILDING:Residential HEAT SOURCE: l lGas ❑Electric ❑Other BUILDING TYPE: ❑✓SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: OCommercial DAccessory Structure TYPE OF PROJECT(check all that apply): [New Construction DAddition ❑Remodel ORepair ❑T.l. OChange of Use ❑Modular OPortable ❑Re-roof DExterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) DOther: DESCRIPTION OF WORK:Repair/install partly ceiling drywal and insulation YlAlt NCI tipie Awf 191 G1 LL cal s 12 Q e l e t. - ep iC i ftQ\a &\ U Vf -- — 1i.4 c: 0-9y-kfatoQf� ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein/s 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.1 am the owner,or l am authorized by the owner of this property to perform the work for which application Is made, ant!1 mnpfy rth'.E S!a!r Ccrrlraricrs Law 1127 F C'W r,id 206.20 A WAC. City of Everett Official Use Only �jJ,�� 06/04/2024 PERMIT# �� ` Q 2-5 Owner/Authorized Agent Signature Date (Revised 4/21/2022)