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gl1. BUILDING PERMIT APPLICATI <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:0140c Ink OnlyPlease):`. :::.i::::::::, ` . . .. . <br /> PRQJECT:SITE.INFORMATION.�.' :.::.:.: ::::`: : :: �::;::� :: .:, :` : :::'Y: :::, .:;::::: ' ;: <br /> PROJECT SITE ADDRESS: STREET 10115 Holly Dr. PARCEL# 28042400201100 <br /> cliry Everett STATE WA Zip 98204 <br /> SUITE/UNIT#: Building V 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 /> . :: .. 0 ..::..... ::: :::... . : .. � .::.:...:.. . .::. ONTACT(tNFORMATION .: :: :::: :; �: :::.:.: .::.::;: �;: ��=;:::�::�'.:�;.....,....;,.:::...::.;,. <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: CadyJ@secprap.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: 5TREET17311 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.cotn <br /> ::.:::.. ..::::.::.:BUILDING INFORMATION <br /> VALUATION OF WORK:$$40,000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevaling fair market value of all 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 ❑✓Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ✓❑Multi-Family-#Units:352 ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ['Remodel ['Repair ❑T.I. OChange of Use <br /> OModular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ['Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage OPool/Hot Tub OTank(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:I have reviewed this application and confirm the Information contained herein Is true end 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.tam 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 RC W and 298.200A WAC. <br /> City of Everett Official Use Only <br /> l PERMIT# 6 n 2 1 D 7 <br /> 11/18/2022 <br /> (i ✓ (I <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />