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PERMIT APPLICATtON <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@evereriwa.gov� wwv✓.evereriwa.gov/permits <br /> (Blue or Black Ink Oniy Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 4�'JZ7 23RD AVE , EVERETT, WA 98203 PROPERTY TAX#: OOG44�JOOOOZ3OO <br /> LEGAL for new construction: Short PlaUsubdivision C'RANADASEAVIEN/ESTATESON.N0.1 BLK0000.� LOl NO.�� (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: GOZA MICHAEL E &CAROLYN HETHERWICK TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReET 4927 23RD AVE , , WA 98203 <br /> CITY EVERETT sTATE wA Z�P 98203 <br /> OWNER PHONE: 4Z5-3O'I-68Z4 OWNER EMAIL: chetherwickg@gmail.com <br /> CONTRACTOR NAME; A.B.S. COI1StfUCtlOt1 LLC <br /> CONTRACTOR ADDRESS: srReeT 10663 NE 132nd PI. <br /> cirr Klfkl8lld srnre WA ziP 98034 <br /> CONTRACTOR PHONE: 425-466-4245 CONTRACTOR EMAIL: kelth@SUft-SpaCG'S.COIII <br /> CONTRACTOR LICENSE#(REQUIRED): ABSCOCL903O$ CITY OF EVERETT BUSINESS LICENSE#(REQUIR ): V � <br /> PRIMARY CONTACT: ❑OWNER jZl CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-466-4245 <br /> Keith Sitzmann CONTACT EMAIL: keith@sun-spaces.com <br /> BUILDING PERMIT APPLICATION <br /> Existing use of Buiiding: Single family Residence Contract Price of rk:$3 � <br /> Proposed Use of Building: Single family Residence Heat Source: ❑G ectric ❑Other <br /> Building Type: ❑SFR-Detached Q1SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New �Addition ❑Remodel ❑Repair ❑T.I. ❑Si n ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Proposed addition is to enclose 200 Sq. Ft. of an existing deck. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): � �/" ���`�'//�'�'�'�v] (,f�A.�/-1{z���� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of �jst of Fi�ctures #of List of Fixtures #of Vsf of Fixtures #of (�st of Fixtures <br /> Fi�rtures Fixtures Fixtures Fintures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg <br /> Forced Air S stems 1 Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(VUash Basin) Drinking Fountain <br /> Water Heater Refrigera6on Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/BarJMop/etc.) Other. <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT.I have reviewed this app/icetion and confirm the information contained herein is true and correct. Work done pursuant to this permit musf comply with <br /> cunent federel,stste,and locel law. The grenting of a permit only authonzes approved work and no deviations therefrom.Devrations musf first be authonzed in wnting from the <br /> Building Official befo�e berng authonzed under any cfrcumstence.I am the owner,or I em authorized 6y the owner of this property to perform the work fo�which applrcation is made, <br /> and I comply with the State Confractors Law 18.27 RCW and 296.200A WAC. <br /> Cify of Everetf Officiel Use Only <br /> ` /O 6 PE IT#'� r /� � O�� <br /> � lJ <br /> OwnedAut rized Agent Signatur Date (Revised 9/23/2016) � "� � <br /> ��1' -7 <br /> !� <br />