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P ILDING PERMIT APPLICA`-7N <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <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 9502 18th Ave W Unit Q PARCEL#: 0048060010090 <br /> clTy Everett STATE WA ZiP 98201 <br /> SUITE/UNIT#: Lot 17 FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): Harrison Pointe <br /> TENANT/BUSINESS NAME(if non-residential):Harrison Pointe Lot 17 <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Harrison Pointe Lot No.: 17 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Pacific Ridge Homes- DR Horton LLC <br /> OWNER MAILING ADDRESS: STREET 17921 Bothell Everett Hwy Ste 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 Homes- DR Horton LLC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):PAC]FRD851 JB CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET 17921 Bothell Everett Hwy Ste 100 <br /> ciTv <br /> Bothell STATE WA ZIP 98012 <br /> CONTRACTOR PHONE:425.939.1164 CONTRACTOR EMAIL:RLClancy@drhorton.com <br /> PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425.939.1164 <br /> Rhonda Clancy CONTACT EMAIL:RLClancy@drhorton.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $350006 00 3Sq I Lk 5(0 ASSOCIATED LAND USE PROJECT#(if applicable):revii22-008 & revii22-007 <br /> (Valuation shall include the prevailing fair market value of all labor,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:New Single Family Home <br /> HEAT SOURCE: ❑Gas DV Electric ❑Other <br /> BUILDING TYPE: ✓❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable [:]Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑✓Other:RB2306-005 Lennon AB <br /> DESCRIPTION OF WORK: <br /> New single family home using Registered Basic RB2306-005 <br /> D [ECIFLEF0 Fe::� <br /> I <br /> O C T 0 5 2023 <br /> CITY OF�p �p� p r TT <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and Cor1'ts�f.W trk�o�ie�tiru of 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/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> rL� 10.02.23 Pn123`c r O <br /> Owner/Authorized Agent Signatu Date (Revised 4/21/2022) <br />