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t <br /> Bl _DING PERMIT APPLICAT''`N <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <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 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) 151 Z PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 7th Ave SE PARCEL M <br /> city Everett STATE WA zip 98208 <br /> SUITEIUNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable):Chelsea Heights Lote1 <br /> TENANTIBUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plattsubdivision: Chelsea Heights Lot No.: 32 (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 /> ciTv Bothell STATE WA zip 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):PACI FICRD851 JB clTY OF EVERETT BUSINESS LICENSE f1(REQUIRED): 5(0 ,3 <br /> CONTRACTOR ADDRESS: STREET1 7921 Bothell Everett Hwy Ste 100 <br /> clTv Bothell STATE WA zip 98012 <br /> CONTRACTOR PHONE:425.939.1164 1CONTRACTOR EMAIL:RLClancy@drhorton.com <br /> PRIMARY CONTACT: p OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE.425.939.1164 <br /> Rhonda Clancy CONTACT EMAIL:RLClancy@drhorton.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $520009-OG 3(00) a 5 D ASSOCIATED LAND USE PROJECT# if applicable):RB2306-001 <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:NIA <br /> PROPOSED USE OF BUILDING:New single family residence <br /> HEAT SOURCE: ❑Gas ©Electric ❑Other <br /> BUILDING TYPE: ✓❑SFR ❑Townhouse [-]Duplex ❑ADU ❑Mufti-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 ❑PoollHot 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 /> f <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 with the State Contractors Law 18.27 RCW and 296.200A WAG <br /> City of Everett Official Use Only <br /> 03.07.24 PERMIT# B 2 � 3 — rl / <br /> OwnerlAuthorize�d Agent Signature Date (Revised 412112022) <br />