Laserfiche WebLink
BUILDING PERMIT APPLICATION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box_ <br /> CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) if57 z PROJECT SITE INFORMATION <br /> PROJECT SiTE ADDRESS: STREE►-&-%6r 7th Ave SE PARCEL#: <br /> cm Everett STATE WA zla 98208 <br /> SUITE/UNIT#: FLOOR M ADDITIONAL LOCATION INFORMATION (if applicable):Chelsea Heights Lot01 <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Chelsea Heights Lot No.: 42 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Pacific Ridge Homes- DR Horton LLC <br /> OWNER MAILING ADDRESS: STREET 17921 Bothell Everett Hwy Ste 100 <br /> CITY Bothell STATE WA zlP 98012 <br /> OWNER PHONE:425.939.1164 1OWNER EMAIL: RLClancy@drhorton.com <br /> CONTRACTOR COMPANY NAME:Pacific Ridge Homes <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):PACIFICRD851 JB CITY of EVERETT BUSINESS LICENSE#(REQUIRED): S �3 <br /> CONTRACTOR ADDRESS: STREET17921 Bothell Everett Hwy Ste 100 <br /> crry Bothell STATE WA ZIP 98012 <br /> CONTRACTOR PHONE:425.939.1164 ICONTRACTOR EMAIL:RLCIanCy RLCIancy@drhorton.com <br /> PRIMARY CONTACT: 121 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425.939.1 164 <br /> Rhonda C I a n cy CONTACT EMAIL:RLClancy@drhorton.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $ 316 b, 'T o ASSOCIATED LAND USE PROJECT# if applicable):RB2306-001 <br /> (valuation shall include the prevailing fair market value of ail labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:N/A <br /> PROPOSED USE OF BUILDING:New Single family residence <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 /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ✓❑Other:RB2306-001 <br /> DESCRIPTION OF WORK: <br /> New single family home using approved Registered Basic RB2306-001 (Thelon AB) <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 1 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 /> City of Everett Official Use Only <br /> 03.07.24 PERMIT# 8 2ID ©7 <br /> 3-- 5 <br /> Owner/Authorized Agent Signature Date (Revised 412112022) <br />