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BUILG PERMIT APPLICATIO E©E0 v En <br /> CITY OF EVERETT PERMIT SERVICES '�tt�t2 <br /> EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requireme nd nttAi of'ciit & Jired f view, <br /> WASHINGTON then drop off completed application plus all required submittal documents to edar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I,(. 14�� r t�t -r"j' <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION LL Permit Services <br /> PROJECT SITEADDRFySS:, sTREET J3702/ NMukilteoBlvd PARCEL#: 00433800004802,00433600004700,00 00000000,0 000u00 <br /> cm, Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: vo _p 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 /> crry Everett STATE WA 2ip 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: STREET950519th 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: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-231-7777 <br /> Vicki Harrison CONTACT EMAIL:vicki@sagehomesnw.com <br /> Tel 5193(' DING INFORMATION <br /> VALUATION OF WORK:$2, ,979A =7- 19rr7.0 (ASSOCIATED LAND USE PROJECT#(if applicable):REVI122-001 <br /> (Valuation shall include the prevailing fair market value of a or,materials,and equipment needed to complete the work,whether actually paid or not.) , \ <br /> EXISTING USE OF BUILDING:NA 1'j�11'� s"od, <br /> PROPOSED USE OF BUILDING:Townhomes <br /> HEAT SOURCE: ❑Gas ©Electric DOther <br /> BUILDING TYPE: ❑SFR I7.ITownhouse ❑Duplex ❑ADU OMulti-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ✓❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.1. ❑Change of Use <br /> [Nodular ❑Portable ORe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> OFence over 7ft high ❑RackStorage OPool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:Construct Building 1 7 Unit Townhouses <br /> 3-202- O,4 ' �04-‘6►o lbQ.-Jo gpa�o A <br /> 9 <br /> &AAIt- 0 ta• ►60)1 Ceti'®' ""`'' <br /> �ts-t t4- [- VW Z2.o.(1-62- - C-p susua -) <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 b, . -being authoriz er 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 I comply wit =State Contr ors La 8.27 RCW and 296,200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> b70(2,- 1?-,?o4 - (-0 <br /> Owner/Aut orized Ag Signature Date (Revised 4/21/2022) <br />