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.w <br /> Nom <br /> BL. _JING PERMIT APPLICATIG11 J ECEIVE <br /> CITY OF EVERETT PERMIT SERVICES r�11 <br /> EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requiremehts and nukR o4cOil auired view, <br /> WA$HINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake p Box. <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov I(yyl r-a Ag T-r <br /> (Blue or Black Ink Only Please) ,(]yL? PROJECT SITE INFORMATION <br /> P _rmit 4ervi .PS <br /> PROJECT SITE ADDRESS: STREET 3719/3702/3648 W Mukilteo Blvd PARCEL#: 00433600004802.00433600004700.00433600004600.00433600004500 <br /> Cm, Everett STATE WA Zip 98203 <br /> SUITE/UNIT#: � l ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME (if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: See attached Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Sage Homes Northwest, LLC <br /> OWNER MAILING ADDRESS: STREET 9505 19th Ave SE, Suite 118 <br /> cm, Everett STATE WA zip 98208 <br /> OWNER PHONE:425-609-8074 OWNER EMAIL: permits@sagehomesnw.com <br /> CONTRACTOR COMPANY NAME:Sage Homes Northwest, LLC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):SAGEHHN932QM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 61991 <br /> CONTRACTOR ADDRESS: STREET 9505 19th Ave SE, Suite 118 <br /> cm,, Everett STATE WA zw 98208 <br /> CONTRACTOR PHONE:425-609-8074 CONTRACTOR EMAIL:vicki©sagehomesnw.com <br /> PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-231-7777 <br /> Vicki Harrison CONTACT EMAIL:vicki@sagehomesnw.com <br /> (cj °LQ BUILDING INFORMATION <br /> VALUATION OF WORK:$2,383,976.05_8c. % Or ASSOCIATED LAND USE PROJECT#(if applicable):REV1122-001 <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:NA ,90 0`)`9N <br /> PROPOSED USE OF BUILDING:Townhomes <br /> HEAT SOURCE: ❑Gas ❑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 El Repair ❑T.I. EChange 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: <br /> DESCRIPTION OF WORK: <br /> Construct Building8 Unit Townhouses <br /> C-, <br /> 17ilbs4•►< 174.v<<22 -opt G `' <br /> l'. A.%.dr* 2165- 0Z2- <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'fhe State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> / r- ) PERMIT# 0(-4C, • <br /> l/ (j <br /> Own rlAutho ' ed Agent Signatu\e ate (Revised 4/21/2022) <br />