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BUSING PERMIT APPLICATI D E©igo <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirem and e o co ����?? y <br /> a uire f review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 2 Ced'rd t 2nd obrInta ' rop Box. <br /> CONTACT INFORMATION: (P)425-257-8810 I (E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION LI I Y Ob EVCt<L t I <br /> PPrmi 5,21 viL:t.:s <br /> PROJECT SITE ADDRESS: STREET 2501 Hot Avenue PARCEL#: 005171 b61 U01 U0 <br /> CITY Everett STATE Washington ZIP 98201 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):OUr Lady of Hope - Sanctuary <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Corporation of the Catholic Archbishop of Seattle Property and Construction Services <br /> OWNER MAILING ADDRESS: STREET 710 Ninth Avenue <br /> CITY Seattle STATE Washington ZIP 98104 <br /> OWNER PHONE:(206) 382-4370 OWNER EMAIL: Gus.Ripple q@SeattleArch.Org <br /> CONTRACTOR COMPANY NAME:V&R Roofing <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):VRSHESM973KM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): —I `JM <br /> CONTRACTOR ADDRESS: sTREET2920 South Cushman Avenue <br /> CITY Tacoma STATE Washington ZIP 98409 <br /> CONTRACTOR PHONE:(253)328-5678 CONTRACTOR EMAIL:Office@VRRoofing.Net <br /> PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:(253) 273-1382 <br /> Robert Rawlings CONTACTEMAIL:RobertR@VRRoofing.Net <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $290000 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:ChUrCh <br /> PROPOSED USE OF BUILDING:ChUrCh <br /> HEAT SOURCE: ❑Gas ❑Electric ❑✓Other unknown-no changes to <br /> BUILDING TYPE: ❑SFR Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑✓Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK:Demolition of entire existing roofing down to structural concrete deck (Leaving <br /> structural concrete deck in place) + Installation of 2-plies of vapor barrier (torch <br /> applied) + Multiple layers tapered insulation R-38 Avgerage (Adhered with low rise <br /> foam insulation adhesives) + 1-layer 1/2" coverboard (Adhered with low rise foam <br /> insulation adhesives)+ 1-ply 0.060 PVC Membrane (adhered with solvent based <br /> bonding adhesives) <br /> 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 <br /> 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 <br /> 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, <br /> and 1 comply with the_St Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />