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e _s <br /> ILDING PERMIT APPLICA N <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: ' =W Mukilteo Blvd PARCEL#: 00433600304802. 700• 450D• + <br /> cny Everett U. !•7"`C, STATE WA Zip 98203 <br /> SUITE/UNIT#: 9 6-g- FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: See attached Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Sage Homes Northwest, LLC <br /> OWNER MAILING ADDRESS: STREET 9505 19th Ave SE,Suite 118 <br /> city Everett STATE WA zip 98208 <br /> OWNER PHONE:425-609-8074 'OWNER EMAIL: permits@sagehomesnw.com <br /> CONTRACTOR COMPANY NAME:Sage Homes Northwest, LLC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):SAGEHHN932QM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 61991 <br /> CONTRACTOR ADDRESS: STREET 9505 19th Ave SE, Suite 118 <br /> crry Everett STATE, WA zip 98208 <br /> CONTRACTOR PHONE:425-609-8074 'CONTRACTOR EMAIL:vicki@sagehomesnw.com <br /> PRIMARY CONTACT: ❑OWNER IZI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-231-7777 <br /> Vicki Harrison CONTACT EMAIL:vicki@sagehomesnw.com <br /> BUILDING.INFORMATION <br /> VALUATION OF WORK:$ -- -77p 0/ 'ASSOCIATED LAND USE PROJECT#(if applicable):REVII22-001 <br /> (Valuation shall include the prevail Ir market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not) <br /> EXISTING USE OF BUILDING:NA <br /> PROPOSED USE OF BUILDING:Townhomes <br /> HEAT SOURCE: ❑Gas ©Electric ❑Other <br /> BUILDING TYPE: ❑SFR OTownhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): IZJNew Construction ❑Addition DRemodel ❑Repair ❑T.I. ❑Change of Use <br /> ❑Modular OPortable ORe-roof ❑Exterior Alteration ['Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage OPool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: EEC EE�\\9L,e ' <br /> Construct Building B, 4 Unit Townhouses D �J <br /> kAl l 1 G MAY 2-3 2023 „J <br /> CITY of EVERETT <br /> Permit Services <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 - . - 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 OM,al be = -- • : i horized under any circumstance,lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and!corn, with,`,tate Con -ctors Law 18.27 RCW and 296.200A WAC. <br /> ) Clty of Everett Official Use Only <br /> kb-3 PERMIT# 3 c0 — 060 <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />