5131 HARBOR LN 2025-01-10 - Laserfiche WebLink

• • woo 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(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5131 Harbor Lane PARCEL#: 00732800000900 CITY Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): n/a LEGAL DESCRIPTION for new construction: Short Plat/subdivision: n/a Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Alex&Jeannette Golitzin OWNER MAILING ADDRESS: STREET 5131 Harbor Lane crry Everett STATE WA ZIP 98203 OWNER PHONE: 425-353-4140 OWNER EMAIL: alexequileedeteom to l ey.e t4 l ack cret?i • to in CONTRACTOR COMPANY NAME: Inclign LLC WA STATE CONTRACTOR LICENSE#(REQUIRED): INCLIL*835M4 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62138 CONTRACTOR ADDRESS: STREET 2516 W Marine View Drive ciTy Everett STATE WA ZIP 98201 CONTRACTOR PHONE: 206-730-4219 CONTRACTOR EMAIL: rich©inclign.com PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑ Xl OTHER(Please Specify)CONTACT: Shockey Planning Group CONTACT NAME: Camie Anderson CON lAL:I PHONE: 425-258-9308 CONTACT EMAIL:canderson@shockeyplanning.Com BUILDING INFORMATION VALUATION OF WORK:$ 75,000 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: SF PROPOSED USE OF BUILDING: SF HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE:XFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular OPortable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) EAccessory Structure ElFence over 7ft high ❑RackStorage ❑Pool/Hot Tub ETank(above ground) ZJOther:Deck Replacement DESCRIPTION OF WORK: Replace existing deck D ECG E I v E) MAY 10 2024 CITY OF EVERETT Permit SarvinAS 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 properly 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 4 �( PERMIT# 5-6-24OS- 020 Owner/Authorized Agent Signature Date (Revised 4/21/2022)