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PERMIT APPLICATION <br /> BUILDING �JIECHANICAL/ PLUMBING /SIGN /5 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 /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 33'I9 3Oth Dt', Everett, �/A PROPERTY TAX#: 290529001014,005760001000,005760002000, <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: POIygOfl WLH, LLC TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREEr 11624 SE 5th Street, Suite 100 <br /> Bellevue �,n WA STATE 98005 Z,P <br /> OWNER PHONE: 425.5H6.77O0 OWNER EMAIL: aI81l.p8C11 C�T pOIygOC1F10t1leS.COf71 <br /> CONTRACTOR NAME: S8CT1@ 2S OWII@f <br /> CONTRACTOR ADDRESS: srH�rT Same as Owner <br /> CI7l' STATE ZIP <br /> CONTRACTOR PHONE:425.5H6.77O0 CONTRACTOR EMAIL:8I8fl.pafll@pOIygOC1I10171@S.COfil <br /> CONTRACTOR LICENSE#(REQUIRED): pOIygWIHC3pW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O�J3222 <br /> PRIMARY CONTACT: L� OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> , CONTACT NAME: CONTACT PHONE: 425.5H6.77O0 <br /> Alan Pani coNrAcr Ennai�: alan.pani@polygonhomes.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: n1/8 Contract Price of Work: $ <br /> Proposed Use of Building: MUltl-F8t7111y TOWI1hOt71eS Heat Source: ❑Gas �Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex �Multi-Family-#of Units: 6 ❑Commercial ❑Industrial <br /> Type of Project: �New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: COt1StfUCt UCllt 'I F Ifl BICIg ZO.4, 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 E1F is 1,344 SF, 322 sf garage, 44 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 #�f Lisi of Fixfures #of List of Fixtures <br /> Fixfures Fixfures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump 3 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater � Bathtub Urinal <br /> � Gas Piping Boiler 3 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 1 Dishwasher Roof Drains <br /> � Clothes Dryer Hookups Other: � Clothes Washer Medical Gas <br /> I Range Hood Water Heater Other: <br /> ' Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the informalion contained herein is true and correct.Work done pursuant to this permit must comply with <br /> current federal,state,and local law. The grantinq of a permit only authonzes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building OKicial be(ore being authorized under any circumstance.I am ihe 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 WAC. <br /> City ol Everett Officiaf Use Only <br /> PERMIT# <br /> Q,Q,GU1, q�►1,1. 04.06.16 ���(���" ' � J� <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br /> iI <br /> l <br />