4419 30TH DR SE 2021-12-15 - Laserfiche WebLink

PERMIT APPLICATION BUILDING ANCHANICAL / PLUMBING / SIGN /==MLINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 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 ADDRESS:4415 30th Dr. SE PROPERTY TAX # 29053200102300 LEGAL for new. construction: Short Plattsubdivision Everett Riverfront -Simpson Lot No.238 (attach copy of long legal description) CONTACT INFORMATION" OWNER NAME: Polygon WLH, LLC TENANT NAME (if Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th, Suite 100 CiTy Bellevue STATE WA ZIP 98005 OWNER PHONE: (425) 586-7700 OWNER EMAIL: alan.pani@polygonhomes.com CONTRACTOR NAME: Polygon WLH, LLC CONTRACTOR ADDRESS: STREET 11624 SE 5th, Suite 100 crry Bellevue STATE WA ZIP 98005 CONTRACTOR PHONE: (425) 586-7700 CONTRACTOR EMAIL: ron.bowen@polygonhomes.com CONTRACTOR LICENSE #(REQUIRED): polygwl863pw CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 053222 PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ® OTHER (Please Specify) Agent CONTACT NAME: Alan Pani CONTACT PHONE: (425) 586-7700 CONTACT EMAIL: alan.pani@polygonhomes.com BUILDING PERMIT APPLICATION"; Existing Use of Building: N/a Contract Price of Work: $ Proposed Use of Building: Single Family Home Heat Source: ❑Gas ❑Electric ❑Other Building Type: ®SFR-Detached ❑SFR-Attached []Duplex ❑Multi -Family-# of Units: ❑Commercial ❑Industrial Type of Project: ®New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign []Sprinkler ❑Demolition []Change of Use DESCRIPTION OF WORK: Construct 1 Single Family Residence, 2640A Plan Type, 1684 SF living space, 428 SF garage & 95 SF covered porch, on new subdivided Division I, 70 SF Home Development ASSOCIATED BUILDING PERMIT # (if applicable): #1502-008 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. 1 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. /n� - f� City of Everett Official Use Only 1�11 .n, �� l aAi , 02/09/2017 PERMIT # �-j Owner/Authorized Agent Signature Date (Revised 1011212015) /Jl