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NMI <br /> BRLDING PERM <br /> IT T APPLICATIlk <br /> EVE c r Z CITY OF EVERETT PERMIT SERVICES <br /> G Y C SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINeTot7 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.govfpermits <br /> (Blue or.Black ink Only Please).'.'. .;.....:.::..:::PROJECT:SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 10115 Holly Dr. PARCEL#: 28042400201100 <br /> cry Everett STATE WA Ztp 98204 <br /> SUITE/UNIT#: Building j FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): <br /> TENANTiBUSINESS 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 /> : :' CON <br /> TACT INFORMATION::::;: ..: .... ...... ....:. .......... ........::::.:.::::..::: .:...:.:.:..:::,.::: <br /> OWNER NAME:Olin Fields Owner LLC <br /> OWNER MAILING ADDRESS: STREET 701 5th Ave, Suite 5700 <br /> Gay 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 /> cmr Woodinville STATE WA zip 98072 <br /> CONTRACTOR PHONE:425-231-7004 CONTRACTOR EMAIL:shane@keckgc.com <br /> PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-498-2332 <br /> Jason Bean ,CONTACTEMAIL:jason@keckgc.com <br /> • 'BUILDING.1NF'IN <br /> FORMATION N :::... : : :: . :: : : :: ;::'::;:.'::`:::`:::::'::::. :;:;: ::;::::::: :`;::;°;. <br /> VALUATION OF WORK:$$40,000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevating 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: I:Gas ❑✓Electric DOthef <br /> BUILDING TYPE: DSFR ❑Townhouse ❑Duplex DADU ❑✓Multi-Family-#Units:352 OCommercial DAccessory Structure <br /> TYPE OF PROJECT(check all that apply): ONew Construction DAddition DRemodel i]Repalr ❑T.I. DChange of Use <br /> OModular ❑Portable ORe-roof ❑Exterior Alteration OTank(above ground) ❑Accessory Structure <br /> DFence over 7ft high DRackStorage DPoollHot Tub DTank(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.lam the owner,or 1 am 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 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 1440aft, Salts 11/18/2022 <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />