Laserfiche WebLink
• • <br /> ism <br /> gel BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov l(W)everettwa.gov/permits <br /> (Blue or!3ack Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 10115 Holly Dr PARCEL#: <br /> CITY Everett - STATE WA ZIP 98204 <br /> SUITE/UNIT#: Building 1C() FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Olin Fields Apartments <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Olin Fields Owner LLC <br /> OWNER MAILING ADDRESS: STREET 701 5th Ave , Suite 5700 <br /> cl,, Seattle STATE WA ZIP 98104 <br /> OWNER PHONE:509-833-6657 OWNER EMAIL: CodyJ@secprop.com <br /> CONTRACTOR COMPANY NAME:Keck General Construction <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):CCKECKGGC855RW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): -Cligapi <br /> T <br /> CONTRACTOR ADDRESS: STREET 17311 135th Ave NE Suite B400 <br /> CITY Woodinville STATE WA ZIP 98072 <br /> CONTAAC-:C::ire GNE:r25-23 i-7004 CONTRACTOR EMAIL:shane@keCkgC.COm <br /> PRIMARY CCN TACT: El OWNER ❑✓ CONTRACTOR LI OTHER(Please Specify) <br /> CONTACT M=: CONTACT PHONE:425-731-7004 <br /> Shane Keck CONTACT EMAIL:shane@keckgc.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: •804 67, 7yv, ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall i ci.;de the prevailing fair market value of all laaor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF Bi3ILDlXG: t!IU`ti Family Housing <br /> PROPOSED ESL SiilLDalvG:MUlti Family Housing <br /> HEAT SOURD_: ❑Gas ❑mectric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑✓Multi-Family-#Units:352 ❑Commercial EAccessory Structure <br /> TYPE OF PRCJ` `✓T(ch&c'<aI.l:flat apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. EChange of Use <br /> ❑Modular _'?ortabls ''i:e-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackSicrage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTI WOR(:remove and replace roof shingles with like and kind material <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.lam the owner,or 1 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 /> PERMIT# <br /> Si ane-Keck 7/25/22 V 1, 0 g e <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br /> y2 . <br />