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13"ILDING PERMIT APPLICA"ON CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, waswtxaron then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) q Z(a PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET-9506 7th AVe SE PARCEL M c(TY Everett STATE WA zIP 98208 SUITEIUNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable):chelsea Heights Lotot TENANTIBUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plattsubdivision: Chelsea Heights Lot No.: 07 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Pacific Ridge Homes- DR Horton LLC OWNER MAILING ADDRESS: STREET 17921 Bothell Everett Hwy Ste 100 CITY Bothell STATE WA ZIP 98012 OWNER PHONE:425.939.1164 1OWNER EMAIL: RLClancy@drhorton.com CONTRACTOR COMPANY NAME:Pacific Ridge Homes WA STATE CONTRACTOR LICENSE#(REQUIRED):PACIFICRD851JB ciTY OF EVERETT BUSINESS LICENSE#(REQUIRED): 5 G D CONTRACTOR ADDRESS: STREET17921 Bothell Everett Hwy Ste 100 c:Tr Bothell STATE WA zIP 98012 CONTRACTOR PHONE:425.939.1 164 1CONTRACTOR EMAIL:RLClancy@drhorton.com PRIMARY CONTACT: I]OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.939.1164 Rhonda Clancy CONTACT EMAIL:RLClancy@drhorton.com BUILDING INFORMATION VALUATION OF WORK: 02@ O"G 306 115 15 ASSOCIATED LAND USE PROJECT# if applicable):RB2306-001 (Valuation shalt include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:N/A PROPOSED USE OF BUILDING:New single family residence HEAT SOURCE: ❑Gas ©Electric ❑Other BUILDING TYPE: ©SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ©New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use I ❑Modular ❑Portable ❑Re-roof El Exterior Alteration ❑Tank(above ground) ❑Accessory Structure i ❑Fence over 7ft high ❑RackStorage ❑PoollHot Tub ❑Tank(above ground) ✓❑Other:RB2306 001 DESCRIPTION OF WORK: New single family home using approved Registered Basic RB2306-001 (Thelon AB) I I i i i r ACKNOWLEDGEMENT.-l have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with € 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 Building Official before being authorized under any circumstance.l am the owner,or l am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAG. City of Everett Official Use Only 03.07.24 PERMIT# Z — 0-7 b Owner/Authorized Agent Slgnatu a Date (Revised 412112022) I E