10115 HOLLY DR BLDG R OLIN FIELDS APTS 2024-06-28

ALDING PERMIT APPLICATivN 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 l(E)PermitServices@everettwa.gov l(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 10115 Holly Dr PARCEL#: 28042400201100 an/ Everett STATE WA ZIP 98204 SUITE/UNIT#: Building R FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable):Building Envelope TENANT/BUSINESS NAME(if non-residential):Olin Fields Apartments LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Olin Fields Owner LLC OWNER MAILING ADDRESS: STREET 701 5th Ave Suite 5700 clTy Seattle STATE WA ZIP 98104 OWNER PHONE:509-833-6657 OWNER EMAIL: CodyJ©secprop.com CONTRACTOR COMPANY NAME:Keck General Construction WA STATE CONTRACTOR LICENSE#(REQUIRED):CCKECKGGC855RW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 64875 CONTRACTOR ADDRESS: STREET17311 135th Ave NE Suite B400 CITY Woodinville STATE WA ZIP 98072 CONTRACTOR PHONE:206-498-2332 CONTRACTOR EMAIL:jasOrl@keCkgc.COm PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-498-2332 Jason Bean CONTACT EMAIL:jason@keckgc.com BUILDING INFORMATION VALUATION OF WORK:$40,000 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:MUlti Family PROPOSED USE OF BUILDING:MUlti Family HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑✓Multi-Family-#Units: ❑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:Demo and reframe existing breezeway to correct slope of breezeway. ECEOVE MAR 01 2024 �J CITY OF EVERETT Permit Services 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. City of Everett Official Use Only PERMIT#v .� 9' JaiL v�1 ear. 2;26i2024 2c (� ' OCow Owner/Authorized Agent Signature Date (Revised 4/21/2022)