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PERMIT APPLICATIO " <br /> BUILDI� MECHANICAL / PLUMBING / SIG�PRINKLER / 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: 35"I 6 31 St Df, Everett, �/VA PROPERTY TAX#: 290529001014,005760001000,005760002000, <br /> 4 017 4 805025 1 <br /> LEGAL for new construction: Short PlaUsubdivision ECIIpS2 Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: POIygOf1 WLH, LLC TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREET 11624 SE 5th Street, Suite 100 <br /> BeIIeVUe aTv WA sTnrE 98005 ziP <br /> OWNER PHONE: 425.586.7700 OWNER EMAIL: a1811.p8f11@pOlygOClhOt712S.COlII <br /> CONTRACTOR NAME: Safl1@ aS OWiI@f <br /> CONTRACTOR ADDRESS: srREEr Same as Owner <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE:425.586.7700 CONTRACTOR EMAIL:aIaCl.p8f11 U�pOIygOClflOtll@S.COfTI <br /> CONTRACTOR LICENSE#(REQUIRED): pOIygWI863pW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): OrJ32Z2 <br /> PRIMARY CONTACT: � OWNER ❑ CONTRACTOR ❑OTHER (Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.586.7700 <br /> Alan Pani coNTAcr EnnAi�: alan.pani@polygonhomes.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: N/a Contract Price of Work: $ 100,800.00 <br /> Proposed Use of Building: MUItI-Fafl'llly TOWf1IlOt11ES Heat Source: ❑Gas �Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex �Multi-Family-#of Units: 4 ❑Commercial ❑Industrial <br /> Type of Project: C�New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: COl1StfUCt U111t 1 D ICl BICIg 'I8.3, a Type A -4 unit building, as part of a 190 Unit Townhome <br /> Development <br /> 4-plex unit is 7,551 total SF, plan type E1D is 1,344 SF, 322 sf garage, and 95 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 Fixtures <br /> Fixfures Fixtures Fixfures Fixfures <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 � 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. 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 iirst be authorized in writing from the <br /> Building Officia/before being authorized under any circumstance. 1 am the owner,or I am authorized by the owner of this property to perform the work fo�which app/ication is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> eJciS� PERMIT# <br /> �rz� ��s� CI �oD�� o � g �, <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) ' <br />