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M3 <br />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 I www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS:4703 31st Ave SE <br />PROPERTY TAX #: <br />LEGAL for new construction: Short Plat/subdivision Everett Riverfront - Simpson Lot No.351 (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Polygon WILT, LLC TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 11624 SE 5th, Suite 100 <br />ciTv Bellevue STATE WA ZIP 98005 <br />OWNER PHONE: 425.586.7763 <br />OWNER EMAIL: connor.king@polygonhomes.com <br />CONTRACTOR NAME: Polygon WLH, LLC <br />CONTRACTOR ADDRESS: STREET 11624 SE 5th, Suite 100 <br />ciTv Bellevue STATE WA ZIP 98005 <br />CONTRACTOR PHONE. 425.586.7763 <br />CONTRACTOR EMAIL: ron.bowen@polygonhomes.com <br />CONTRACTOR LICENSE #(REQUIRED): polygwl863pw <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): OS3222 <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ® OTHER (Please Specify) Agent <br />CONTACT NAME: Connor King <br />CONTACT PHONE: 425.586.7763 <br />CONTACT EMAIL: connor.king@polygonhomes.com <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: N/a <br />Contract Price of Work: $ <br />Proposed Use of Building: Single Family Home <br />I 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 ❑Remodel ❑Repair ❑T.I. ❑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 />ASSOCIATED BUILDING PERMIT # (if applicable): q� I ©—"QC'q <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: X New _ Addn _Alteration _Repair <br />Type of Project: X New _Addn _Alteration _Repair <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C —Air Handling Units <br />Heat Pump <br />3 <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater <br />2 <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />5 <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />1 <br />Water Heater <br />1 <br />iShower <br />Floor Drain <br />1 <br />Gas Fireplace <br />Wood Stove <br />1 <br />Kitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />1 <br />Dishwasher <br />Roof Drains <br />1 <br />Clothes Dryer Hookups <br />Other: <br />1 <br />Clothes Washer <br />Medical Gas <br />Range Hood <br />Other: N I I t <br />6 <br />Exhaust Fan <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />SPRINKLER <br />/ SUPPRESSION <br />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 />C�"Y►�►1-D �L `" bn 07/8/19 <br />Owner/Authorized Agent Signdfure Date <br />City of Everett Official Use Only <br />PERMIT #0 I ja J <br />:1 <br />(Revised 1011212015) <br />/ 1 <br />