4510 OLYMPIC BLVD 2023-04-07 - Laserfiche WebLink

BQDING PERMIT APPLICATIc 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4510 Olympic Boulevard PARCEL#: 0068200000100,200,300,&400 clTv Everett STATE WA ZIP 98203 SUITE/UNIT#: 1-4 FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): iv 4,z) LEGAL DESCRIPTION for new construction: Short Plat/subdivision: MFR Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Boulevard Condo Association OWNER MAILING ADDRESS: STREET 402 Wood Place clTv Everett STATE WA ZIP 98203 OWNER PHONE:425-879-1360 OWNER EMAIL: wenstar@att.net att.net CONTRACTOR COMPANY NAME:Cornerstone Roofing, Inc. WA STATE CONTRACTOR LICENSE#(REQUIRED):CORN ERIO1 1 CM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 335 4,0 CONTRACTOR ADDRESS: STREET 17624 15th Ave SE, #101A CITY Bothell STATE WA ZIP 98012 CONTRACTOR PHONE:425-485-01 1 1 CONTRACTOR EMAIL:kristy@cornerstoneroofing.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-4.85-01 1 1 Kristy CONTACT EMAIL:kristy@cornerstoneroofing.com BUILDING INFORMATION VALUATION OF WORK:$31,116.00 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:MFR PROPOSED USE OF BUILDING: HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU EMulti-Family-#Units: ECommercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable I IRe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ERackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:Remove existing comp. Install plywood over portion of roof with skip sheathing. Install new composition. 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 aw 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# g ^� �� GORY d 7 ner/Author' Agen Si n e Date (Revised 4/21/2022)