4510 RIVERFRONT BLVD 2022-01-25 - Laserfiche WebLink

PERMIT APPLICATIO "OWL BUILDIN ECHANICAL I PLUMBING/SIGN RINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION 290529004003,290529001021,290529001011, PROJECT SITE ADDRESS:4510 Riverfront Blvd, Everett, W?ROPERTY TAX#: 290529001014,005/60001000,005760002000, 004390805017,004390805025,009953000010 LEGAL for new construction: Short Plat/subdivision Riverfront SF, LLC Lot No. 216 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Polygon WLH, LLC TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th Street, Suite 100 Bellevue CITY WA STATE 98005 zIP OWNER PHONE: 425.586.7700 OWNER EMAIL: alan.pani@polygonhomes.com CONTRACTOR NAME: Same as Owner CONTRACTOR ADDRESS: STREET Same as Owner CITY STATE ZIP CONTRACTOR PHONE:425.586.7700 CONTRACTOR EMAIL:alan.pani@polygonhomes.com CONTRACTOR LICENSE#(REQUIRED): polygw1863pw CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 053222 PRIMARY CONTACT: IN OWNER 0 CONTRACTOR 0 OTHER(Please Specify) I CONTACT NAME: CONTACT PHONE: 425.586.7700 Alan Pani CONTACT EMAIL: alan.pani@polygonhomes.com BUILDING PERMIT APPLICATION Existing Use of Building: N/a Contract Price of Work:$_ �_) Proposed Use of Building: Single Family Home Heat Source: OGas I2Electric DOther Building Type: ®SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: ❑Commercial ❑Industrial _ Type of Project: ®New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Garage conversion to a temporary sales office ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: X New Addn __Alteration Repair Type of Project: X_New Addn _- Alteration Repair #of #of List of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT:1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,slate,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 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. and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only - i PERMI gt Q.ea.rz, b_ f cuti, 03/14/18 s ��"' 609V;,...1 Owner/Authorized Agent Signature Date (Revised 10/12/2015)