2201 GRAND AVE 2021-12-16 - Laserfiche WebLink

• 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 I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2201 Grand Ave PARCEL#: clrr Everett STATE WA zip 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Renee Peterson LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Rene Peterson OWNER MAILING ADDRESS: STREET 2201 Grand Ave cm, Everett STATE WA zip 98201 OWNER PHONE:(425)320-6111 OWNER EMAIL: renee.p1@comcast.net 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 c„-y Snohomish STATE WA zlp 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 -liana Cooper CONTACT EMAIL:tiana@fourseasonsroof.com BUILDING INFORMATION VALUATION OF WORK:$22356.00 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:Multifamily PROPOSED USE OF BUILDING:Multifamily- no change 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 LllRemodel ❑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) ❑Other: DESCRIPTION OF WORK: Remove existing shingles to roof deck, provide underlayment and asphalt shingles. 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# V 01Tiana Cooper Date'202102 26 rnnsas.0 fl00' 4/5/21 Owner/Authorized Agent Signature Date (Revised 2/8/2021)