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4512 RIVERFRONT BLVD 2019-03-14
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4512 RIVERFRONT BLVD 2019-03-14
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3/14/2019 4:35:15 PM
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3/14/2019 4:35:10 PM
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Address Document
Street Name
RIVERFRONT BLVD
Street Number
4512
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PERMIT APPLICATION <br /> 41010/L" BUILDING =CHANICAL/ PLUMBING/SIGN / .INKLER/ 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 /> r PROJECT SITE INFORMATION 290529004063,296529001021,290529001011, <br /> PROJECT SITE ADDRESS:4512 Riverfront Blvd, Everett, wAROPERTY TAX#: 290529001014,005/60001000,005/60002000, <br /> 004390805017,004390805025,009953000010 <br /> LEGAL for new construction: Short Plat/subdivision Riverfront SF, LLC Lot No. 215 (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: Dil 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 IYIElectric ❑Other <br /> Building Type: ®SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: I24New ❑Addition 0 Remodel ❑Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: New construction, single family homes - plan 3580 C elevation <br /> Garage: 433 sf, 1st floor: 1,070 sf, 2nd floor: 1,472 sf and covered porch: 120 sf <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Ivt/) Q,, Grp <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 - • ride ion 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 1/4.. 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.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 /> PERMI <br /> OlT# <br /> ata-n, b_ Pa i. 08/18/16 GI"DQj ' dZ / <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) C-C)7 <br /> ) <br />
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