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BUILDING PERMIT APPLICATION U ECIEVE <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requiremen • ,d nu ri�f o es r1� ired fo iew, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 344 Cedar&Vela 2hd1d 4 ake D ox. <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov I )everettwa.gov/permits <br /> (Blue or Black Ink Only Please) 36 PROJECT SITE INFORMATION GIl Y 0t tvEKE I I <br /> s. P t I C LY.Lc6§ a3a oPROJECT SITE ADDRESS: STREET 3. Se W Mukilteo Blvd PARCEL#: 00'38"G4B°z•°°" ' <br /> cry Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: _ IA4I� ,�' 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 /> CITY 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: STREET9505 19th Ave SE, Suite 118 <br /> CITY Everett STATE WA ZIP 98208 <br /> CONTRACTOR PHONE:425-609-8074 CONTRACTOR EMAIL:vicki@sagehomesnw.com <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-231-7777 <br /> Vicki Harrison CONTACT EMAIL:vicki@sagehomesnw.com <br /> �j%(c d 2Q BUILDING INFORMATION <br /> VALUATION OF WORK: $2,383,976.08:r8s 9 j,f2( ASSOCIATED LAND USE PROJECT#(if applicable):REVI122-001 <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 ' 3 �''� <br /> PROPOSED USE OF BUILDING:Townhomes <br /> HEAT SOURCE: ❑Gas ZElectric ❑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 /> El Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: <br /> Construct Buildin(}13 Unit Townhouses <br /> 3,4sr ort z -Ob` <br /> 't'�p..Aw,`; WrIo 6", o 2-2- <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 wit State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Use Only <br /> PERMIT# 30 O(6l <br /> Own r/AuthoriEed Agent Signal ate (Revised 4/21/2022) <br />