1730 112TH ST SW BLDG D SAGE APARTMENTS 2025-04-07

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gov l(W)everettwa.govlpermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1730 112th St SW PARCEL#: city Everett STATE WA zip 98204 SUITEIUNIT M FLOOR M. ADDITIONAL LOCATION INFORMATION (if applicable): Building D TENANTIBUSINESS NAME(if non-residential):Sage Apartments LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Existing Multi Family Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:L13 MCS South, LLC (Owner Contact Dan Ricci) OWNER MAILING ADDRESS: STREET 2111 152nd Ct E. clTy Bradenton STATE FL Zip 34212 OWNER PHONE:508-864-6140 OWNER EMAIL: dan@113mcs.com CONTRACTOR COMPANY NAME:Camp Construction Services WA STATE CONTRACTOR LICENSE#(REQUIRED):CC CAMPCCS806CD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 15139 South Past Oak Rd clTy Houston STATE TX ZIP 77053 CONTRACTOR PHONE:503-979-5379 CONTRACTOR EMAIL:dpratt@campconstruction.com PRIMARY CONTACT: ❑OWNER Cl CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:503-979-5379 David Pratt CONTACT EMAIL:dpratt@campeonstruction.com BUILDING INFORMATION VALUATION OF WORK: $14,976.00 ASSOCIATED LAND USE PROJECT#(if applicable):N/A (Valuation shall include the prevailing fair market value or ali labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Multi-Family PROPOSED USE OF BUILDING:Multi-Family HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑✓Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑PoollHot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Remove and dispose of existing comp-shingle roofing and replace with new comp-shingle roofing. Like for like. ACKNOWLEDGEMENT:!have reviewed this application and confirm the Information contained herein Is true and correct.Work done pursuant to this permit must comply with 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 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, and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. City of Everett Official Use Only j PERMIT# g7 ?.O�i --4 Z-q Owner/Authorized Agent Signature Date (Revised 412112022)