BLD2023-0040+Application+1.10.2023_4.18.32_PM+3307869CITY OF EDMONDS nn BuildingPermit.com
Building Application
#1252174 - Single-family house interior remodel
Applicant
First Name
Last Name
Company Name
Olena
Gaivoronska
GO-desiqn
Number Street
Apartment or Suite Number E-mail Address
2002 101th Ave SE
Unit 3 gaivoronska.olena(c_gmail.com
City State
Zip
Phone Number Extension
Lake Stevens WA
98258
(425) 595-0691
Contractor
Company Name
HOME CARE CONTRACTORS LLC
Number Street
Apartment or Suite Number
10634 E Riverside Dr
Suite 250
City
State Zip
Phone Number Extension
BOTHELL
WA 98011
(206)4465656
State License Number
License Expiration Date
UBI # E-mail Address
HOMECCC834M1
7/29/2023
604138157 alexn(cD_homecarecontractors.com
Project Location
Number Street
Floor Number Suite or Room Number
23519 78TH AVE W
City
Zip Code
County Parcel Number
EDMONDS
98026
00465600001200
Associated Building Permit Number
Tenant Name
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name Last Name or Company Name
Austin & Jutila Stephan D Blacker
Number Street Apartment or Suite Number
23519 78TH AVE W
City State Zip
EDMONDS WA 98026
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 1/10/2023 Submitted By: Olena Gaivoronska
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CITY OF EDMONDS MyguildingPermit.com
Building Application #1252174 - Single-family house interior remodel
Project Contact
Company Name: GO -design
Name: Olena Gaivoronska Email: gaivoronska.olena@gmail.com
Address: 2002 101th Ave SE Unit 3 Phone #: (425) 595-0691
Lake Stevens WA 98258
Project Type Activity Type Scope of Work
Single Family Residential Remodel Residence
Project Name: Single-family house interior remodel
Description of Single-family house interior remodels, including the existing master bedroom, bathroom,
Work: and kitchen remodeling, existing openings alteration, and converting the existing
wood -burning fireplace to gas. No Ground Disturbing Activity.
Project Details
Mechanical Included?
Mechanical work will occur during this project.
Plumbing Included?
Plumbing work will occur during this project.
Work Location
Work Description/Location (example: 1st floor,
Master Bath, Garage)
Valuation
Fair Market Value of Remodeling Work
Exterior Changes?
The work does not involve changes to the exterior
Contact Information
Owner Email Address
Single-family home interior remodels, including the
existing master bedroom, bathroom, and kitchen
remodeling, existing openings alteration, and converting
the existing Wood burning fireplace to gas. No Ground
Disturbing Activity
$50,000
stephanjutila@comcast.net
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