10012 1ST DR SE CHASE BANK 2025-08-20

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4815 Evergreen Way PARCEL#: 00581900000102 cITY Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Chase Bank LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Claremont Village Station OWNER MAILING ADDRESS: STREET 11501 Northlake Dr. cITY Cincinnati STATE OH Zlp 45249 OWNER PHONE:971-416-6919 OWNER EMAIL: alicia.shaw@jpmchase.com CONTRACTOR COMPANY NAME:Nations Roof Mountain, LLC. WA STATE CONTRACTOR LICENSE#(REQUIRED):NATIORM828P6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 67553 CONTRACTOR ADDRESS: STREET 10621 W. Executive Dr. CITY Boise STATE ID ZIP 83713 CONTRACTOR PHONE:208-322-2474 CONTRACTOR EMAIL:jwilliams@nationsroof.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:208-322-2474 Jordan Williams CONTACT EMAIL:jwilliams@Nationsroof.com BUILDING INFORMATION VALUATION OF WORK:$184,600.00 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:Bank PROPOSED USE OF BUILDING:Bank HEAT SOURCE: []Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: (]Commercial ❑Accessory Structure TYPE OF PROJECT(check a//that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑✓Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Tear off existing roof, install R-38 insulation, install Dens Deck, install new TPO. 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 Contr!7t0157taw4S8 7 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# -�- Owner/Authorized Agent Signa re Date (Revised 412112022)