1810 100TH PL SE 2024-01-05 - Laserfiche WebLink

`r BI .,DING PERMIT APPLICATIN 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 1(W)everettwa.gov/permits (Blue or.Black ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1810 100th PL SE PARCEL#: clrr Everett STATE Wa. ZIP SUITE/UNIT#: FLOOR#: tb -,ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): Avlr LLA LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Durable Roofing OWNER MAILING ADDRESS: STREET PO Box 72 CITY Hebron STATE CT. ZIP 06248 OWNER PHONE:1-860-228-9337 OWNER EMAIL: len a+Ycir-roofing.com CONTRACTOR COMPANY NAME:Commercial industrial Roofin WA STATE CONTRACTOR LICENSE#(REQUIRED):C©MMei*205JJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 029058 CONTRACTOR ADDRESS: STREET 3601 121st Street SW CITY Lynnwood STATE ZIP 98087 CONTRACTOR PHONE:4257544048 CONTRACTOR EMAIL:lenncir roofing.com PRIMARY CONTACT: ❑OWNER O CONTRACTOR D OTHER(Please Specify) CONTACT NAME: �/ Dugan CONTACT PHONE:425-754-4048 Lennox D u ry g a n. CONTACT EMAIL:len@cir-roofing.com BUILDING INFORMATION VALUATION OF WORK:$25,000.00 ASSOCIATED LAND USE PROJECT#(if applicable):WA (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:Kindergarden PROPOSED USE OF BUILDING:same HEAT SOURCE: ❑Gas OElectric DOther BUILDING TYPE: DSFR DTownhouse ❑Duplex DADU ❑Multi-Family-#Units: OCommerciai DAccessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction DAddition ❑Remodel ❑Repair DT.I. DChange of Use ❑Modular DPortable ORe-roof ❑Exterior Alteration Drank(above ground) DAccessory Structure ❑Fence over 7ft high DRackStorage DPool/Hot Tub Drank(above ground) DOther. DESCRIPTION OF WORK:Remove existing roof material and replace with new... 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.lam 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. PERMIT# City of Everett Official Use Only tUco — OLb Owner/Authorized Agent Signatu^N^"ire Date (Revised 2/8/2021) I/2_