9612 19TH AVE SE F 2023-12-18 - Laserfiche WebLink

6_.LDING PERMIT APPLICATI-14 CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P) 425-257-8810 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 9612 19TH AVE SE, EVERETT, WA 98208 PARCEL #: 28051800403000, 28051800403200 CITY EVERETT STATE WA ZIP 98208 SUITEMNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION (if applicable): TENANTIBUSINESS NAME (if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: 69-74 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: PACIFIC RIDGE HOMES OWNER MAILING ADDRESS: STREET 17921 BOTHELL EVERETT HWY, SUITE 100 CITY BOTHELL STATE WA ZIP 98012 OWNER PHONE: (425) 438-8444 OWNER EMAIL: RLClancy@pacificridgehomes.com CONTRACTOR COMPANY NAME: PACIFIC RIDGE - DRH, LLC WA STATE CONTRACTOR LICENSE #(REQUIRED): PAC IFRD851 JB CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): CONTRACTOR ADDRESS: STREET 17921 Bothell Everett HWY #100 CITY Bothell STATE WA ZIP 98012 CONTRACTOR PHONE: 425.939.1164 CONTRACTOR EMAIL: RLClancy@pacificridgehomes.com PRIMARY CONTACT: 0 OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Rhonda Clancy & Jason Atkin CONTACT PHONE: 425.939.1 164 CONTACT EMAIL: RLClancy@pacificridgehomes.com and JWAtkin@pacificridgehomes.com BUILDING INFORMATION VALUATION OF WORK: $1,608,147.62 1D s* 742;10 Z4. 60 ASSOCIATED LAND USE PROJECT # (if applicable): (Valuation shall include the prevailing fair market value of all labor, materials, and equipment needed to complete the work, whether actually paid or not.) EXISTING USE OF BUILDING: N/A PROPOSED USE OF BUILDING: MULTY-FAMILY RESIDENTIAL HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR❑Townhouse ❑Duplex ❑ADU ✓❑Multi -Family - # Units: 6 ❑Commercial ❑Accessory Structure TYPE OF PROJECT (check all that apply) : ©New, Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re -roof ❑Exterior Alteration ❑Tank (above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub []Tank (above ground) ❑Other: DESCRIPTION OF WORK: New construction of 6 unit 3 story multi -family type VB townhouse. Part of a 13 building new townhome community. II � 1 1 � r 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 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 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. 07.15.2022 Owner/Authorized Agent Sign&ure Date City of Everett Official Use Only PERMIT # fij22v-7— 0(a3 (Revised 412112022)