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PERMIT APPLICATIOI" <br /> M <br /> BUILDING ) MECHANICAL/ PLUMBING / SIGN i JPRINKLER/ 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 I(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 /> I <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 <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: 0 OWNER ❑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 <br /> Existing Use of Building:Vacant Contract Price of Work:$TBD <br /> Proposed Use of Building:Apartments Heat Source: ❑Gas DElectric DOther <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑✓Multi-Family-#Units:90 ❑Commercial ❑Accessory Structure <br /> Type of Project: ✓❑New ❑Addition ❑Remodel ❑Repair DT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: ,,Four Corners Apartments - Building E" -- Construct a new 5-over-1 multifamily residential building with <br /> level 1 parking garage with 90 for-rent apartments and 75 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 /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Count/ Count of <br /> Fixture <br /> ListFixture Fixture <br /> List of Fixtures Fixtures Count List of Fixtures List of Fixtures <br /> Count <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 /> 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/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/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 WAC. <br /> DocuSigned by: <br /> I City of Everett Official Use Only <br /> Via I�• ff 10/12/2020 PER— I -o '�/� <br /> BC41600E12EB481... I D ` 1 2 <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) / f/ <br />