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477 PERMIT APPLICATION <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 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:•4617 31st Ave SE PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Everett Riverfront Simpson Lot No.346 (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 /> crry 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: ❑OWNER D CONTRACTOR ®OTHER(Please Specify) Agent <br /> CONTACT NAME: Alan Pani 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: Gas ❑Electric ❑Other <br /> Building Type: ®SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ®New ❑Addition ID Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> New construction,single family homes-plan 3015 B elevationGarage:443 sf, 1st floor:855 sf,2nd floor: 1,115 sf and covered <br /> porch:62 sf <br /> #3 2'008 i 3 ���� c •c( �.� f <br /> ASSOCIATED BUILDING PERMIT#(if applicable): /y <br /> V 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 /> Gas Piping Boiler 5 Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater \,,?I,effigeration 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 Walsh Heater Other: ��� � i , A 1 <br /> 6 Exhaust Fan Sink(Service/Bar/Mop/etc.) I Other: ALdA7 (�;Y Jl r k) <br /> SPRINKLER/ SUPPRESSION SYSTEM <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 /> A_ .- � City of Everett Official Use Only <br /> PERMIT# <br /> l�.t✓G Xid l <br /> - f atti. 12/19/18 <br /> n <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br /> Cr, <br /> V7_ <br />