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PERMIT APPLICATION <br /> BUILDING /MECHANICAL/PLUMBING /SIGN /SPRINKLER/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 SITE.-..INFORMATION- 9052660"-4V6,290529001021.290529001011;:, <br /> PROJECT SITE ADDRESS: 3420 30th Dr, Everett, WA PROPERTY TAX#: 290529001014,005/60001000,005/60002000, <br /> 004390805017,004390805025,009953000010 <br /> LEGAL for new construction: Short Plat/subdivision Eclipse Lot No. I' (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@polygonhomes.com <br /> CONTRACTOR LICENSE#(REQUIRED): polygwl863pw CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 053222 <br /> PRIMARY CONTACT: CR 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 /> <„ BUILDING PERMIT APPLICATION <br /> Existing Use of Building: N/a Contract Price of Work:$ 87,225.00 <br /> Proposed Use of Building: Multi-Family Townhomes Heat Source: ['Gas IBElectric ['Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ['Duplex ®Multi-Family-#of Units: 6 ❑Commercial ❑Industrial <br /> Type of Project: New ['Addition El Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler El Demolition El Change of Use <br /> DESCRIPTION OF WORK: Construct Unit E in Bldg 25.4, a Type F-6 unit building, as part of a 190 Unit Townhome <br /> Development <br /> 6-plex unit is 12,732 total SF, plan type E is 1,163 SF, 508 sf garage, and 64 sf deck/patio <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL. PERMIT APPLICATION u,... <br /> PLUMBINGTERMNT 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 /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump 3 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems O• Unit Heater 1 Bathtub Urinal <br /> Gas Piping Boiler 3 Lavatory(Wash Basin) Drinking Fountain <br /> 1 Water Heater 0 Refrigeration 2 Shower Floor Drain <br /> 1 Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting 1 Dishwasher Roof Drains <br /> 1 Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> A IF Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER`/SUPPRESSION SYSTEM -e <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.I am the 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 of Everett Official Use Only <br /> nn ,A, -- PERMIT# <br /> a i cuw 04.06.16 C1(004- 061 <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) y <br /> �v <br />