5910 EVERGREEN WAY TOMORROWS HOPE 2021-11-02

• • BUILDING PERMIT APPLICATION 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 (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5910 Evergreen Way PARCEL#: cin Everett STATE WA zip 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable • TENANT/BUSINESS NAME(if non-residential):Mitat'L ra ue LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Mitch Larue OWNER MAILING ADDRESS: STREET 5910 Evergreen Way ciTy Everett STATE WA ZIP 98203 OWNER PHONE:4253476556 x 272 OWNER EMAIL: mitchelllarue@housinghope.org CONTRACTOR COMPANY NAME:Four Seasons Roofing -- WA STATE CONTRACTOR LICENSE#(REQUIRED):FOURSRS016QA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 36927 CONTRACTOR ADDRESS: STREET 17903 SR 9 SE cr-y Snohomish STATE WA zip 98296 CONTRACTOR PHONE:(425)388-9906 CONTRACTOR EMAIL:tiana@fourseasonsroofing.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425)388-9906 Tiana Cooper CONTACT EMAIL:tiana@fourseasonsroof.com BUILDING INFORMATION VALUATION OF WORK: $28821.00 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:Commercial PROPOSED USE OF BUILDING:Commercial -no change HEAT SOURCE: EGas ❑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 EModular ❑Portable ✓❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Remove existing PVC to roof deck, provide new PVC roofing. 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 PE'rtill Tiana Cooper Data-,ozi os ae+0 03.a5 am, 8/27/21 Owner/Authorized Agent Signature Date (Revised 2/8/2021)