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E <br /> S BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 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 I(W)everettwa.gov/permits <br /> (Blue or Black ink Only Please) :::' ::::: :: ..:.:PROJECT SITE INFORMATION: ::::::::::; ,:.,' :: : '` ::;:' ::;::: <br /> PROJECT SITE ADDRESS: STREET 10115 Holly Dr. PARCEL#: 28042400201100 <br /> cm.Everett STATE WA zip 98204 <br /> SUITE/UNIT#: Building T 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 IN ORMATION :::::: ::.;:.;.:,,;: ::: :::::° .'.:, j :$;;;: '.:::::: •:,: : :; <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.com <br /> CONTRACTOR COMPANY NAME:Keck General Construction <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):CCKECKGGC855RW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 64875 <br /> CONTRACTOR ADDRESS: sTREEr17311 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: 0 OWNER ✓❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-498-2332 <br /> Jason Bean CONTACT EMAIL:jason@keckgc.com _ <br /> .. ... ... . ... .. .. ... . .... . ........: .. .. . I . . . . . . .. <br /> '.`BU LDING IN OR ..F MATIO <br /> VALUATION OF WORK:$$40,000 ASSOCIATED LAND USE PROJECT#fit applicable): <br /> (Valuation shall include the prevailing fair market value of at labor,materials,and equipment needed to complete the work,whether actuaty paid or not.) <br /> EXISTING USE OF BUILDING:Multi-Family , <br /> PROPOSED USE OF BUILDING:MUlti-Family <br /> HEAT SOURCE: OGas ✓❑Electric DOther <br /> BUILDING TYPE: DSFR ❑Townhouse ODuplex DADU I:Multi-Family-#Units:352 DCommercial DAccessory Structure <br /> TYPE OF PROJECT(check all that apply): [New Construction DAddition ❑Remodel ©Repair DT.I. DChange of Use <br /> ❑Modular ❑Portable DRe-roof DExterior Alteration ❑Tank(above ground) DAccessory Structure <br /> OFence over 7ft high ❑RackStorage ❑Pool/Hot Tub Drank(above ground) DOther: <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: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.I am the owner,or tam 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 ROW and 296.200A WAC. <br /> City of Everett Official Use Only 0 <br /> 1 <br /> PERMIT# m <br /> 11/18/2022 b <br /> �� J I " / <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />