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BL..DING PERMIT APPLICATILA <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 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 1819 19' EW PARCEL#: 00480600102000,00480600102104 <br /> EVERETT <br /> CITY STATE w°' ZIP 98204 <br /> SUITE/UNIT#: A-C FLOOR#: 1-3 ADDITIONAL LOCATION INFORMATION (if applicable): Building C <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Benton Square Lot No.: 15-17 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:PACIFIC RIDGE-DRH, LLC <br /> OWNER MAILING ADDRESS: STREET 17921 BOTHELL EVERETT HWY,SUITE 100 <br /> CITY BOTHELL STATE WA ZIP 98012 <br /> OWNER PHONE:(425) 939.1164 OWNER EMAIL: RLClancy@drhorton.com <br /> CONTRACTOR COMPANY NAME:PACIFIC RIDGE - DRH, LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):PACIFRD851 JB d CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):'tD(D I-03 <br /> CONTRACTOR ADDRESS: STREET 17921 BOTHELL EVERETT HWY, SUITE 10 <br /> aTY BOTHELL STATE WA ZIP 98012 <br /> CONTRACTOR PHONE:425.939.1164 CONTRACTOR EMAIL:RLClancy@drhorton.com &JWAtkin@drhorton.com <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425.939.1164 <br /> Rhonda Clancy and Jason Atkin CONTACT EMAIL:RLClancy@drhorton.com &JWAtkin@drhorton.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $887,61 .34 3= 2 �$70.7g ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of g016bor,materials,and equipment needed 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 2/lElectric ❑Other <br /> BUILDING TYPE: ❑SFR ❑✓Townhouse ❑Duplex ❑ADU ✓❑Multi-Family-#Units:3 ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑✓New Construction ❑Addition ❑Remodel ❑Repair FIT.I. ❑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 3 unit Townhome, part of a 5 building community <br /> �3 L._-i I(A 1 n�) C <br /> 9 g is d g e" <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 I am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 08.11.23 13 2_3 0'9 — 0 -7 Lo <br /> Owner/Authorized Agent Signatikfe Date (Revised 412112022) <br />