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9628 19TH AVE SE G 2025-10-27
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9628 19TH AVE SE G 2025-10-27
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Last modified
10/27/2025 8:41:17 AM
Creation date
9/7/2023 11:10:31 AM
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Address Document
Street Name
19TH AVE SE
Street Number
9628
Unit
G
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BI' .DING PERMIT APPLICATI <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br />WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br />CONTACT INFORMATION: (P) 425-257-8810 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits <br />(Blue,or.BlackInk Only, Please)-,:'_. PROJECTSITE-INFORMATION <br />PROJECT SITE ADDRESS: STREET 9702, 9620 19TH AVE SE, EVERETT, WA 98208 PARCEL M 28051800403000, 28051800403200 <br />CITY EVERETT STATE WA ZIP 98208 <br />SUITE/UNIT #: A - G FLOOR M 1-3 ADDITIONAL LOCATION INFORMATION (if applicable): Grayson Square Bldg G <br />TENANT/BUSINESS NAME (if non-residential): <br />LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Grayson Square Lot No.: 45-51 (attach copy of long legal description) <br />CONTACT INFORMATION„ . <br />OWNER NAME: PACIFIC RIDGE HOMES - DRH LLC <br />OWNER MAILING ADDRESS: STREET 17921 BOTHELL EVERETT HWY, SUITE 100 <br />CITY BOTHELL STATE WA ZIP 98012 <br />OWNER PHONE: (425) 939-1164 <br />OWNER EMAIL: RLClancy@pacificridgehomes.com <br />CONTRACTOR COMPANY NAME: Pacific Ridge Homes - DRH LLC <br />WA STATE CONTRACTOR LICENSE #(REQUIRED): PACIFRD851JB <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): IJC 4- 3 <br />CONTRACTOR ADDRESS: STREET 17921 Bothell Everett Hwy Ste 100 <br />cny Bothell STATE WA ZIP 98012 <br />CONTRACTOR PHONE: 425.939.1164 <br />CONTRACTOR EMAIL: RLClancy@pacificridgehomes.com <br />PRIMARY CONTACT: [DOWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Rhonda C I a n cy <br />CONTACT PHONE: 425.939.1164 <br />CONTACT EMAIL: RLClancy@pacificridgehomes.com <br />BUILDING INFORMATION ,. <br />VALUATION OF WORK: $ 2,043,184.56%14 Z 9 i, 86 3 - 5® <br />JASSOCIATED LAND USE PROJECT # (if applicable): <br />(Valuation shall include the prevailing fair market value of all labor, materials, and equipment needed to complete the work, whether actually paid or not.) <br />EXISTING USE OF BUILDING: N/A <br />PROPOSED USE OF BUILDING. MULTI -FAMILY RESIDENTIAL <br />HEAT SOURCE: ❑Gas ©Electric ❑Other <br />BUILDING TYPE: ❑SFR ❑✓ Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: 7 []Commercial ❑Accessory Structure <br />TYPE OF PROJECT (check all that apply) : ❑✓ New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use <br />❑Modular ❑Portable ❑Re -roof ❑Exterior Alteration ❑Tank (above ground) ❑Accessory Structure <br />❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank (above ground) ❑✓ Other: New 3 story 7 unit townhome bldg <br />DESCRIPTION OF WORK: <br />New 3 story, 7 unit townhome building <br />I& Z S V Imo" A ve- SE U <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 />03.01.23 <br />Date <br />City of Everett Official Use Only <br />-PERMIT # <br />(Revised 412112022) <br />
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