5221 23RD AVE W 2023-04-10 - Laserfiche WebLink

Ble_DING PERMIT APPLICATI I 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)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5221 23RD AVE W PARCEL#: 00734800002300 cm, EVERETT STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: ATTACHED Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:PERRY AND KATHY GRANT OWNER MAILING ADDRESS: STREET 5221 23RD AVE W clTv EVERETT STATE WA ZIP 98203 OWNER PHONE:425-422-7896 OWNER EMAIL: perrynkathyg@gmail.com CONTRACTOR COMPANY NAME:Summit Design and Construction LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):SUMMIDC798B2 CITY OF EVERETT BUSINESS LICENSE#(REQUI ED): CONTRACTOR ADDRESS: STREET22O5 99TH AVE SE CITY Lake Stevens STATE WA ZIP 98258 CONTRACTOR PHONE:206-605-8995 CONTRACTOR EMAIL:JEFFSPESOCK@ME.COM PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR m OTHER(Please Specify) architect CONTACT NAME: CONTACT PHONE:206-542-3734 Heidi Helgeson, H2D Architecture+ Design CONTACT EMAIL: heidi@h2darchitects.com BUILDING INFORMATION VALUATION OF WORK:$60,000 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:SINGLE FAMILY RESIDENCE PROPOSED USE OF BUILDING:SINGLE FAMILY RESIDENCE HEAT SOURCE: ❑Gas DElectric DOther no change BUILDING TYPE: 0SFR ❑Townhouse ❑Duplex DADU DMulti-Family-#Units: DCommercial DAccessory Structure TYPE OF PROJECT(check all that apply): ONew Construction tAddition DRemodel DRepair ❑T.I. OChange of Use DModular DPortable ❑Re-roof DExterior Alteration ❑Tank(above ground) DAccessory Structure DFence over 7ft high DRackStorage 0Pool/Hot Tub ❑Tank(above ground) DOther: DESCRIPTION OF WORK: DECK ADDITION AND OUTDOOR COVERED AREA AT NEW DECK. 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 Zi-gbifti\Akei 191 V01113 6PA PERh I IT# 0 r. Owner/Authalized Agent ignature Date (Revised 2/8/2021) �z l