3000 41ST ST 2023-05-17 - Laserfiche WebLink

• • PERMIT APPLICATION BUILDING /MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 4wrT 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 11Z p b qt°�„-t PROPERTY TAX#: '41st St&Riverfront Blvd. LEGAL for new construction: Short Plattsubdivision Overlook at Riwnfrnnt Lot No.T-QQQ (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Polygon WLH, LLC TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th St,Suite 100 CITY Bellevue STATE WA ZIP 98005 OWNER PHONE: 425.586.7700 OWNER EMAIL: jamie.aubrey@polygonhomes.com CONTRACTOR NAME: Polygon WLH, LLC CONTRACTOR ADDRESS: STREET same as above CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: eddy.stevens@polygonhomes.com CONTRACTOR LICENSE#(REQUIRED): 603422796 CITY OF EVERETT BUSINESS LICENSE#(REQUIRE ):053221 PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425.766.4235 Eddy Stevens,on-site PM CONTACT EMAIL: eddy.stevens gon iqrnes.com BUILDING PERMIT APPLICATION Existing Use of Building: N/A Contract Price of Work: 7,500.00 Proposed Use of Building: permanent entry monument Heat Source: ❑Gas Electric-A]Other N/A Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-4 of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Re air ❑T.I. U&Qn ❑S rinkler ❑Demolition ❑Chan a of Use DESCRIPTION OF WORK: Permanent entry monument to the west side of the entrance into the Overlook community immediately after existing the entrance bridge.The entry monument would consist of an etched bolder,a trellis standing behind,landscaping and uplighting.Please see accompanying plans for details. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn _Alteration Repair Type of Project: _New Addn _Alteration Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher IRoof Drains Clothes Dryer Hookups Other: Clothes Washer I Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc. Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads 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 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.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 10/12/161 (010 Owner/Authorized Agent Signature ) Date (Revised 10/1212015) ��z