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PERMIT APPLICATION <br /> 4 BUILDING/MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) .]J SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2415 11th St14 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Highlander Associates TENANT NAME(If Commercial): Highlander Apartments <br /> OWNER MAILING ADDRESS: STREET PO Box 673 <br /> CITY Bellevue STATE WA ZIP 98201 <br /> OWNER PHONE: 206-793-1476 OWNER EMAIL: Tom.Armstrong@forumregroup.com <br /> CONTRACTOR NAME: RoofCorp of WA <br /> CONTRACTOR ADDRESS: STREET 3425 S 146th St <br /> CITY Tukwila STATE WA ZIP 98168 <br /> CONTRACTOR PHONE: 206439-9991 CONTRACTOR EMAIL: ddelgado@roofcorp.com <br /> CONTRACTOR LICENSE#(REQUIRED): ROOFCWIOO7Q 1 CITY OF EVERETT BUSINESS LICENSE#(R,QUIRED): <br /> PRIMARY CONTACT: 0 OWNER 15,1 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-439-9991 <br /> Daniel Delgado CONTACT EMAIL: ddelgado@roofcorp.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Apartments Contract Price of Work:$47234.00 <br /> Proposed Use of Building: Apartments Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex Multi-Family-#of Units: 30 ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Remove existing asphalt roofing system down to the existing plywood deck,which will stay in plac- nstall a <br /> layer of fire-resistant base sheet, and install a new 60Mil TPO roof mechanically attached. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT •PLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _ ..n _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Was =asin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen ' &Disposal Grease Trap <br /> Gas Range Ducting Dishw. her Roof Drains <br /> Clothes Dryer Hook •s Other: Clo es Washer Medical Gas <br /> Range Hood ater Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRI KL /SUPPRESSION SYSTEM <br /> I Ch•m'N I or Water I No.of Heads <br /> ACKNOWLED EMENT: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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> l City of Everett Official Use Only <br /> 03102116 PERM �'0 (.4 <br /> Owner/AutIior a Agent Signature Date (Revised 9/23/2016) J� <br />