Laserfiche WebLink
#1:-a <br /> PERMIT APPLICATIOI <br /> BUILDING ; MECHANICAL / PLUMBING / SIGN SPRINKLER/ DEMOLITION <br /> 44W <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:•4613 Riverfront Blvd PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivisionEverett Riverfront-Simpson Lot No.305 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Polygon WLH, LLC TENANT NAME (If Commercial): <br /> OWNER MAILING ADDRESS: STREET 11624 SE 5th,Suite 100 <br /> CITY Bellevue STATE WA ZIP 98005 <br /> OWNER PHONE: (425)586-7700 OWNER EMAIL: alan.pani@polygonhomes.com <br /> CONTRACTOR NAME Polygon WLH. LLC <br /> CONTRACTOR ADDRESS: STREET 11624 SE 5th, Suite 100 <br /> CITY Bellevue STATE WA ZIP 98005 <br /> CONTRACTOR PHONE: (425)586-7700 CONTRACTOR EMAIL: ron.bowen@polygonhomes.com <br /> CONTRACTOR LICENSE#(REQUIRED): polygwl863pw CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 053222 <br /> PRIMARY CONTACT: 0 OWNER ❑ CONTRACTOR ® OTHER(Please Specify) Agent <br /> CONTACT NAME: Alan Pam CONTACT PHONE:(425)586-7700 <br /> CONTACT EMAIL: alan.pani@polygonhomes.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: N/a Contract Price of Work: $ <br /> Proposed Use of Building: Single Family Home Heat Source: 0 Gas ❑Electric ❑Other <br /> Building Type: ®SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial 0 Industrial <br /> Type of Project: ®New DAddition El Remodel El Repair DTI. ❑Sign ❑Sprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> Construct 1 Single Family Residence.2640A Plan Type, 1684 SF living space,428 SF garage&95 SF covered porch, on new <br /> subdivided Division III,83 SF Home Development <br /> ASSOCIATED BUILDING PERMIT#(if applicable, ail) D it- 1)01 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: X New Addn Alteration Repair Type of Project: X New Addn Alteration Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump 3 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater 2 Bathtub Urinal <br /> 1 Gas Piping Boiler 5 Lavatory(Wash Basin) Drinking Fountain <br /> 1 Water Heater \,_/1" "\_,,,FThf{ige.ratie4:L. 1 Shower Floor Drain <br /> 1 Gas Fireplace Wood Stove 1 Kitchen Sink& Disposal Grease Trap <br /> Gas Range Ducting 1 Dishwasher Roof Drains <br /> 1 Clothes Dryer Hookups Other: 1 Clothes Washer Medical Gas <br /> Range Hood T . '11(Vater Healer - .. Other: <br /> 5 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other.\'J1[y_ iyy1A <br /> Oft(,/� . <br /> `r�q, O <br /> SPRINKLER/ SUPPRESSION SYSTEM I C�Ci M <br /> Number of Heads <br /> 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 <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> """"'n" <br /> PERMIT# <br /> � <br /> � � <br /> C <br /> " ' l[ G2�11.(. 12/19/18 1)1) (a c) <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />