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• PERMIT APPLICATIOIO <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />4M7T 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: <br />2922 47th St SE Everett WA <br />PROPERTY TAX #: <br />LEGAL for new construction: Short Plat/subdivision Riverfront-Simpson Lot No.360 (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 Street, Suite 100 <br />Bellevue CITY WA STATE 98005 ZIP <br />OWNER PHONE: 425.586.7763 <br />OWNER EMAIL: connor.king@polygonhomes.com <br />CONTRACTOR NAME: Same as Owner <br />CONTRACTOR ADDRESS: STREET Same as Owner <br />CITY STATE ZIP <br />CONTRACTOR PHONE: 425.586.7763 <br />CONTRACTOR EMAIL:ron.boWen@polygonhomes.com <br />CONTRACTOR LICENSE #(REQUIRED): polygwl863pW <br />I CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 053222 <br />PRIMARY CONTACT: ® OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />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:New construction, single family homes - plan 3580 A .elevations Garage: 433 sf, 1st floor: <br />1,074 sf, 2nd floor: 1,472 sf and covered porch: 12 sf <br />ASSOCIATED BUILDING PERMIT # (if applicable)4+# 6 <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 />Water Heater <br />R <br />1 <br />Shower <br />Floor Drain <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 />a ter <br />I <br />Other: UM V14 <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. / am the owner, or / 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 />CO-► L'0-ti dKlj,na 08/27/19 <br />Owner/Authorized Agent Si ature Date <br />City of Everett Official Use Only <br />PE RM ITI� 1`;t V' <br />006 <br />(Revised 1011212015) <br />i� <br />