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BL—PING PERMIT APPLICATInN <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop 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 <br /> PROJECT SITE ADDRESS: STREET 5010 View Drive PARCEL#: 29053200301800 <br /> CITY Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Lowell Elementary School <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Everett Public Schools Facilities&Planning <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE:(425) 923-6251 OWNER EMAIL: jcollins@everettsd.org <br /> CONTRACTOR COMPANY NAME:Wayne's Roofing, Inc. <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):WAYNESR205Q5 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 18045 <br /> CONTRACTOR ADDRESS: STREET PO Box 2287 <br /> CITY Sumner STATE WA ZIP 98390 <br /> CONTRACTOR PHONE:(253)320-9485 CONTRACTOR EMAIL:dj@waynesroofing.com <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:(425)828-8948 <br /> Kevin Ore m u s CONTACT EMAIL:koremus@hoarch.com <br /> BUILDING INFORMATION E L:11\`/ <br /> VALUATION OF WORK: $1,200,000.00 ASSOCIATED LAND USE PROJECT# pplicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actua or nc)AR C 7 2023 <br /> EXISTING USE OF BUILDING:Elementary School <br /> PROPOSED USE OF BUILDING:No change- Elementary School CIT Y OF EVERETT <br /> HEAT SOURCE: ❑✓Gas ❑Electric ❑Other Permit SefViccs <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:This project consists of replacement of the existing composition shingle roofing, built-up <br /> low slope roofing, gutters and associated roof flashing of the entire facility excluding the <br /> covered play shed. <br /> 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 <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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAD. <br /> City of Everett Official Use Only <br /> Pi1230 a -10S•Qi <br /> Ow er/Authorized Agent ignature Date (Revised 4/21/2022) <br />