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41577PERMIT APPLICATI•II I <br /> BUILDINC7ECHANICAL/ PLUMBING/SIG —RINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVI <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE;INFORMATION•290529004003,290529001021,;290529001011, <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: 290529001014,005160001000,005/60002000, <br /> 4510 31st Ave SE, Everett, WA 98201 004390805017,004390805025,009953000010 <br /> LEGAL for new construction: Short Plat/subdivision Riverfront SF, LLC Lot No.249 (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 /> CIN 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: DR 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:$ <br /> Proposed Use of Building: Single Family Home Heat Source: ❑Gas ®Electric ❑Other <br /> Building Type: ®SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: 124New ❑Addition ❑Remodel El Repair CIT.!. ❑Sign ❑Sprinkler El Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: New construction, single family home - plan 3020 C elevation <br /> Garage: 463 sf, 1st floor: 869 sf, 2nd floor: 1,367 sf and covered porch: 129 sf <br /> ASSOCIATED BUILDING PERMIT#(if applicable): #1502-004 <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 /> 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 \ N_ R ra err`— 1 Shower Floor Drain <br /> I Gas Fireplace Wood Stove 1 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 Hoodr Other: <br /> d Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> rNumber 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 /> PERMIT# <br /> O Ja.►T. �_ Pante 11/14/160\.106— a) <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />