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PERMIT APPLICATION <br /> "111:-"A <br /> BUILDINC-ECHANICAL/ PLUMBING /SIGN • RINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITEINFORMATION 290529004003;290529001021,290529001011, <br /> PROJECT SITE ADDRESS:4419 31st Ave SE, Everett, WA PROPERTY TAX#: 290529001014,005/60001000,005/60002000, <br /> 004390805017,004390805025,009953000010 <br /> LEGAL for new construction: Short Plat/subdivision Riverfront SF, LLC Lot No. 272 (attach copy of long legal description) <br /> CONTACT<INFORMATION .. <br /> OWNER NAME: Polygon WLH, LLC TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 11624 SE 5th Street, Suite 100 <br /> Bellevue CITY WA STATE 98005 ZIP <br /> OWNER PHONE: 425.586.7700 OWNER EMAIL: alan.pani@polygonhomes.com <br /> CONTRACTOR NAME: Same as Owner <br /> CONTRACTOR ADDRESS: STREET Same as Owner <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE:425.586.7700 CONTRACTOR EMAIL:alan.pani@pOlygOrlhOmes.COm <br /> CONTRACTOR LICENSE#(REQUIRED): polygwl863pw CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 053222 <br /> PRIMARY CONTACT: IX OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.586.7700 <br /> Alan Pani CONTACT EMAIL: alan.pani@polygonhomes.com <br /> polygonhomes.com <br /> BUILDING"PERMIT"APPLICATION ,,.::' <br /> Existing Use of Building: N/a Contract Price of Work:$ <br /> Proposed Use of Building: Single Family Home Heat Source: ❑Gas ®Electric ❑Other <br /> Building Type: IXSFR-Detached ❑SFR-Attached 0 Duplex ❑Multi-Family-#of Units: ❑Commercial 0 Industrial <br /> Type of Project: Pg New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: New construction, single family homes - plan 3015 C elevation <br /> Garage: 436 sf, 1st floor: 837 sf, 2nd floor: 1,115 sf and covered porch: 62 sf <br /> ASSOCIATED BUILDING PERMIT#(if applicable): #1502-005 <br /> MECHANICAL PERMITAPPLICATION " ' " " PLUMBING"PERMIT APPLICATION <br /> ' <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 /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump 3 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater 2 Bathtub Urinal <br /> Gas Piping Boiler 5 Lavatory(Wash Basin) Drinking Fountain <br /> 1 Water Heater `P\-1/.\---Rfr eratiort-N. 1 Shower Floor Drain <br /> 1 Gas Fireplace Wood Stove 1 Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting 1 Dishwasher Roof Drains <br /> 1 Clothes Dryer Hookups Other: 1 Clothes Washer _Medical Gas <br /> Range Hood .�) Other: <br /> 6 -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 first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.lam the owner,or lam 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 of Everett Official Use Only <br /> PERMIT { i <br /> ata,n. h_ Pan.i, 07/06/16 (J O�- OO <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) 1 <br />