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BUILDING PERMIT APPLICATIG,v <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 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: STREET ?) � t .' aW PARCEL #: 00480600102000, 00480600102104 <br />CITY EVERETT i/ki) I fi I STATE WA ZIP 98204 <br />SUITE/UNIT #: A - G FLOOR #: 1 - 3 ADDITIONAL LOCATION INFORMATION (if applicable): Bldg A <br />TENANT/BUSINESS NAME (if non-residential): <br />LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Benton Square Lot No.: 1 - 7 (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: PACIFIC RIDGE HOMES <br />OWNER MAILING ADDRESS: STREET 17921 BOTHELL EVERETT HWY, SUITE 100 <br />CITY BOTHELL STATE WA ZIP 98012 <br />OWNER PHONE: (425) 939-1164 <br />OWNER EMAIL: RLClancy@drhorton.com <br />CONTRACTOR COMPANY NAME: Pacific Ridge - DRH, LLC <br />WA STATE CONTRACTOR LICENSE #(REQUIRED): PACIFRD851 JB <br />G <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />CONTRACTOR ADDRESS: STREET 17921 Bothell Everett Hwy Ste 100 <br />CITY Bothell STATE WA ZIP 98012 <br />CONTRACTOR PHONE:425.939.1164 <br />CONTRACTOR EMAIL: RLClancy@drhorton.com & JWAtkin@drhorton.com <br />PRIMARY CONTACT: El OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Rhonda Clancy & Jason Atkin <br />CONTACT PHONE:425.939.1164 <br />CONTACT EMAIL: RLClancy@drhorton.com & JWAtkin@drhorton.com <br />BU ING INFORMATION <br />VALUATION OF WORK: $ 2,045,097.78 ij = Zq Z ,� Z ASSOCIATED LAND USE PROJECT # (if applicable): <br />(Valuation shall include the prevailing fair market value of all I r, materials, and equipment n eded to complete the work, whether actually paid or not.) <br />EXISTING USE OF BUILDING: N/A <br />PROPOSED USE OF BUILDING: MULTI -FAMILY RESIDENTIAL <br />HEAT SOURCE: ❑Gas ❑✓ Electric ❑Other <br />BUILDING TYPE: ❑SFR ❑✓ Townhouse ❑Duplex ❑ADU ❑✓ Multi -Family - # Units: 7 ❑Commercial ❑Accessory Structure <br />TYPE OF PROJECT (check all that apply) : ZNeW Construction ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Change of Use <br />[]Modular ❑Portable ❑Re -roof El Exterior Alteration ❑Tank (above ground) ❑Accessory Structure <br />❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank (above ground) ❑Other: <br />DESCRIPTION OF WORK: <br />New construction of 3 story 7 unit Townhome, part of a 5 building community <br />p�u�ld�n�A <br />Ave Ij Un 1 f A <br />ACKNOWLEDGEMENT.." 1 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 / 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 />Owner/Authorized Agent Sig <br />City of Everett Official Use Only <br />08.11.23 PERMIT # S?,-30?- O <br />)ate (Revised 412112022) <br />