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PERMIT APPLICATIC <br /> BUILDIN` , MECHANICAL/ PLUMBING / SIGN . .iPRINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:8102 Evergreen Way PROPERTY TAX#:28050700307000 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Four Corners, LLC TENANT BUSINESS NAME(Commercial): Four Corners Apartments <br /> OWNER MAILING ADDRESS: STREET 19000 NE 8th Street, Suite 1200 <br /> CITY Bellevue STATE WA ZIP 98004 <br /> OWNER PHONE: 425-453-9551 OWNER EMAIL:tom.neubauer@heartlandwa.com 1 <br /> CONTRACTOR NAME:Heartland Construction LLC <br /> CONTRACTOR ADDRESS: STREET 10900 NE 8th Street, Suite 1200 <br /> CITY Bellevue STATE WA ZIP 98004 <br /> CONTRACTOR PHONE:425-453-9551 CONTRACTOR EMAIL:tom.neubauer@heartlandwa.com <br /> CONTRACTOR LICENSE#(REQUIRED):HEARTCL828OF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60418 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:206-204-0512 <br /> Seth Terry CONTACT EMAIL:setht@johnsonbraund.com <br /> BUILDING INFORMATION 1 <br /> Existing Use of Building:Vacant Contract Price of Work:$TBD _ __ I <br /> Proposed Use of Building:Apartments Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑✓Multi-Family-#Units:70 ❑Commercial ❑Accessory Structure <br /> Type of Project: ✓❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: ',Four Corners Apartments - Building A" -- Construct a new 5-over-1 multifamily residential building with <br /> level 1 parking garage with 70 for-rent apartments and 50 parking stalls as a part of a larger development totalling 430 units in <br /> 5 separate residential buildings. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> 1 MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION 1 <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> t Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.of Heads <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 I comply with the State Contractors Law 18.27 RCW and 296.200A WA C <br /> —DocuSigned by: City of Everett Official Use Only <br /> 10/12/2020 PER81_. �+ <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) I4_ <br />