2802 BROADWAY VOLUNTEERS OF AMERICA 2022-07-29

MEI BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL 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)PermitServices@everettwa.gov 1(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2802 Broadway- n PARCEL#: 00439166301900 crry Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Volunteers Of America LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Volunteers Of America OWNER MAILING ADDRESS: STREET 2802 Broadway Avenue c,n Everett STATE WA ZIP 98203 OWNER PHONE:425-212-2908 OWNER EMAIL: dbehn@voaww.org CONTRACTOR COMPANY NAME:ZUIU Stabilities dba Lifetime Roofing L F .1 R g'# he P WA STATE CONTRACTOR LICENSE#(REQUIRED):604542504 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62031 CONTRACTOR ADDRESS: STREET11335 NE 122nd Way ciTy Kirkland STATE WA ZIP 98034 CONTRACTOR PHONE:(425) 287-1480 CONTRACTOR EMAIL:Off Ce@lifetimeroofer.com PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) General Manager CONTACT NAME: CONTACT PHONE:(614) 372-3397 Dominique Dyball CONTACT EMAIL:dom@lifetimeflatroofs.com BUILDING INFORMATION VALUATION OF WORK: $72,951.48 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:Volunteer Organization PROPOSED USE OF BUILDING: 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 ElPortable ERe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:Install a synthetic separation sheet, 1/2" EPS fanfold, & mechanically fastening a 60 mil (white) PVC membrane on top of existing torch down roof that has 4' of insulation on top of 1/2" plywood deck 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 �'�� 06/17/2022 PERMIT# Z 0 4 g 5wner/Authorized Ag t Signatures Date (Revised 4/21/2022) k