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• <br /> 1■Ilr <br /> 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 /> WASHINGTO N then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425-257-88101(E)PermitServices@everettwa.gov 1(W)everettwa.gov/permits <br /> (Blue or Blank Ink Only Please) ::::::°::.: `.:.::':;PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 10115 Holly Dr. PARCEL#: 28042400201100 <br /> CITY Everett STATE WA zIP 98204 <br /> SUITE/UNIT#: Building Id 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 /> .;' CONT ACT:INFORMQTION.:..': <br /> OWNER NAME:Olin Fields Owner LLC <br /> OWNER MAILING ADDRESS: STREET 701 5th Ave, Suite 5700 <br /> CITY Seattle STATE WA ZIP 98104 <br /> OWNER PHONE:509-833-6657 OWNER EMAIL: CodyJ@secprOp.COr <br /> CONTRACTOR COMPANY NAME:Keck General Construction <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):CCKECKGGC855RW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 64875 <br /> CONTRACTOR ADDRESS: STREET17311 135th Ave NE Suite B400 <br /> CITy Woodinville STATE WA zip 98072 <br /> CONTRACTOR PHONE:425-231-7004 CONTRACTOR EMAIL:shane@keckgc.com <br /> PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-498-2332 <br /> Jason Bean CONTACT EMAiL:jason@keokgc.com <br /> :.:::: BUILDINGiNFORMATION <br /> VALUATION OF WORK:$$40,000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of ail labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:Multi-Family <br /> PROPOSED USE OF BUILDING:MUlti-Family <br /> HEAT SOURCE: ❑Gas IlElectric ❑Other <br /> BUILDING TYPE: USER ❑Townhouse ❑Duplex ❑ADU l iMulti-Family-#Units:352 ❑Commerc€ai ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): :New Construction ❑Addition ❑Remodel ❑✓Repair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ORe-roof ❑Exterior Alteration OTank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑Rackstorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other. <br /> DESCRIPTION OF WORK:Exterior deck repair. Demolition of damaged wood and repair of wood with like and <br /> kind materials according to plans. Application of waterproofing detail according to <br /> plans. <br /> 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 <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!am authorized by the owner of this property to perform the work for which application Is made, LI <br /> and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 11/18/2022 3 2l 1 [ -0 c/ 3 <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />