12115 19TH AVE SE THE LAKEHOUSE APARTMENTS 2023-07-03

BLDING PERMIT APPLICATON CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 12115 19th Ave SE PARCEL#: crry Everett STATE WA ZIP 98208 SUITE/UNIT#: Mail Kiosk FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):The Lakehouse Apartments LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:AUK Silverlake LLC OWNER MAILING ADDRESS: STREET 12115 19th Ave SE oily Everett STATE WA ZIP 98208 OWNER PHONE:206-236-2756 OWNER EMAIL: bnorthcott@dev-serv.com CONTRACTOR COMPANY NAME:Star Roofing & Construction, Inc. WA STATE CONTRACTOR LICENSE#(REQUIRED):CCSTARRCI994KH CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 38721 CONTRACTOR ADDRESS: STREET16912 9th Ave SE CITE, Mill Creek STATE WA ZIP 98012 CONTRACTOR PHONE:425-290-7827 CONTRACTOR EMAIL:billing@starroofinggroup.com PRIMARY CONTACT: 0 OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-754-7032 Greg Ostolaza CONTACT EMAIL:greg@starroofinggroup.com BUILDING INFORMATION VALUATION OF WORK:$500 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Multi-Family PROPOSED USE OF BUILDING:Multi-Family HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑✓Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑✓Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) LiOther: DESCRIPTION OF WORK:Like for like roof replacement. 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 4-2-2021 2-1 D 4- © 19 Owner/Authorized Agent Signature Date (Revised 2/8/2021) ( '�/