5828 14TH DR W 2023-09-27 - Laserfiche WebLink

BLiING PERMIT APPLICATICill? 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 1(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5828 14th Dr W PARCEL#: 00847700500100 cITY Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Keaton's Landing LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Jeff Barnhart OWNER MAILING ADDRESS: STREET 5828 14th Dr W CITE Everett STATE WA ZIP 98203 OWNER PHONE:206-755-7578 OWNER EMAIL: jmbarnhartl4@gmail.com 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 CITY Snohomish STATE WA ZIP 98296 CONTRACTOR PHONE:(425) 388-9906 CONTRACTOR EMAIL:tiana@fourseasonsroofing.com PRIMARY CONTACT: ❑OWNER ✓1 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425) 388-9906 Tiana Brown CONTACT EMAIL:tiana@fourseasonsroof.com BUILDING INFORMATION VALUATION OF WORK:$23,096 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: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ElCommercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable E IRe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) DOther Re-Roof DESCRIPTION OF WORK: Remove existing roofing down to sheathing, replace with inkind material. 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/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# Tiana Cooper D1g1a°YsgnedbyT1anaC 9/28/2022 t �/�t/I L1-• Date.2021.02.28 10:03'35-Ofl'00 Owner/Authorized Agent Signature Date (Revised 2/8/2021)