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, <br /> � PERMIT APPLICATION <br /> BUILDING"`�AECHANICAL / PLUMBING / SIGN / INKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> PRaJECT SITE INFORMATION 2ga529004003,29052900�021,290529001011, <br /> PROJECT SITE ADDRESS: 33�5 3Otfl DI', Everett, �/�/A PROPERTY TAX#: � , <br /> 004390805017,004390805025,009953000010 <br /> LEGAL for new construction: Short Plat/subdivision Eclipse Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: POIygOCI WLH, LLC TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srHEET 11624 SE 5th Street, Suite 100 <br /> Bellevue �,N WA STATE 98005 Z,P <br /> OWNER PHONE: 425.5H6.77O0 OWNER EMAIL: Blafl.paCll@pOlygOtlhOI71eS.00171 <br /> CONTRACTOR NAME: SBtlle 8S OWt12f <br /> CONTRACTOR ADDRESS: siKEEi SafTl@ aS OWtI@f <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE:425.5H6.77O0 CONTRACTOR EMAIL:al811.p8111 Q�pOIygOIIIlOt1l@S.COCTI <br /> CONTRACTOR LICENSE#(REC2UIRED): pOIygWIH63pW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O�J3Z22 <br /> PRIMARY CONTACT: [�OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.5HB.77OO <br /> Alan Pani coNra,cT Ennai�: alan.pani@polygonhomes.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: N�8 Contract Price of Work: $ <br /> ProPosed use of B��id��q: Multi-Family Townhomes Heat Source: ❑Gas �Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex �Multi-Family-#of Units: 6 ❑Commercial ❑Industrial <br /> Type of Project: C�9New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: COIIStfUCt Ufllt 3A Iil Bldg ZO.6, a Type B - 6 unit building, as part of a 190 Unit Townhome <br /> Development <br /> 6-plex unit is 11,005 total SF, plan type E3A is 1,548 SF, 389 sf garage, and 69 sf porch/patio <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: X New _ Addn _Alteration _Repair Type of Project: X New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fiztures <br /> Fixfures Fixfures Fixfures Fixtures <br /> A/C—Air Handling Units Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater � Bathtub Urinal <br /> Gas Piping Boiler 5 Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting � Dishwasher Roof Drains <br /> � Clothes Dryer Hookups Other: � Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT:1 have reviewed this application and confirm the informalion contained herein is true and correct. Work done pursuant to this perrnit must comply with <br /> current federal,slate.and loca!law. The granfing of a permit only authorizes approved work and no deviations therefrom.Deviafions must first be authorized in writing from the <br /> Building Official be(ore being authonzed under any circumstance.I am the owner,or 1 am aulhorized by the owner of this propeRy to perform the work for which application is made, <br /> and I compiy with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# /' I ��, ` ' Q <br /> 1�q�1'!, �_ �Q.1'U. 04.06.16 C� �lUV`( �O� `�' <br /> OwnerlAuthorized Agent Signature Date (Revised 10/12/2015) q� <br /> ! 7 <br /> (, <br />