6101 EVERGREEN WAY 2023-02-06 - Laserfiche WebLink

mmi BALDING PERMIT APPLICATJ EVERETT CITY OF EVERETT PERMIT SERVICES 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/pennits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 6101 Evergreen Way PARCEL#: 0138412 crry Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential):Ben Amundson LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Ben Admunson OWNER MAILING ADDRESS: STREET 6101 Evergreen Way ciTy Everett STATE WA zip 98203 OWNER PHONE:(425)355-3822 OWNER EMAIL: ben@generalcarwash.com CONTRACTOR COMPANY NAME:Four Seasons Roofing WA STATE CONTRACTOR LICENSE#(REQUIRED):FOURSRS016QA CITY OF EVERETT BUSINESS UCENSE#(REQUIRED): 36927 CONTRACTOR ADDRESS: STREET 17903 SR 9 SE crre Snohomish STATE WA zip 98298 CONTRACTOR PHONE:(425)388-9906 CONTRACTOR EMAIL:Liana@fourseasonsroofing.com PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Brown PHONE:(425)388-9906 Tt a n a Brown CONTACT EMAIL:liana@fourseasonsroof.com BUILDING INFORMATION VALUATION OF WORK:$42,487 !ASSOCIATED LAND USE PROJECT#(if applicable): (Vaktation shall include the prevaifmg 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: DGas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: [Z Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair DTI ❑Change of Use ❑Modular ❑Portable IZIRe-roof DExterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑PoollHot Tub ❑Tank(above ground) Zi Other.Re Roof DESCRIPTION OF WORK: Remove existing roofing down to sheathing, replace with inkind material. ACKNOWLEDGEMENT:1 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 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 lam the owner,or t am authorized by the owner of this property to perform the work for which application is made, and t comply with the State Contractors Law 18.27 RCW and 296.200A WAG. City of Everett Official Use Only nano Cooper ' L 9/28/2022 PE y 2 ` 0^V I l Owner/Authorized Agent Signature Date (Revised 2/8/2021) I/Z.