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PERMIT APPLICATION <br /> //'' /!-I-"L BUILDII /MECHANICAL I PLUMBING I SIGN l SPS LNKQLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> ' 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 i(E)everetteps@everettwa.gov I www.everettwa.govlpermits <br /> (1 14,or.B1.4411 k Only Plea I PROJECT SITE'INFORNIIATION • . <br /> PROJECT SITE ADDRESS: 2601 Summit Ave , 01),1- L PROPERTY TAX#: 00-5168-594-011-00 <br /> LEGAL for new construction: Short Plat/subdivision N/A Lot No, (attach copy of long legal description) <br /> CON 1°ACT,INFORTIO,N'; m <br /> OWNER NAME: Evergreen Recovery Centers TENANT NAME(If Commercial): N/A <br /> OWNER MAILING ADDRESS: STREET 2601 Summit Ave <br /> CIT( Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 4254935310 OWNER EMAIL: mgese@evergreenrc.org <br /> CONTRACTOR NAME: Roofing by Pr, LLC <br /> CONTRACTOR ADDRESS: STREET 13407 Meadow Drive <br /> cm Snohomish STATE WA as 98290 <br /> CONTRACTOR PHONE: 425-335-0209 CONTRACTOR EMAIL: PRCOfStruCtiOrt❑@frOntier.COmm <br /> CONTRACTOR LICENSE#(REQUIRED): 603622442 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (\301\.., <br /> PRIMARY CONTACT: OWNER ❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: 0��r Vi C-04 2 t�j CONTACT PHONE:425-280-7919 <br /> Bruce Soule B y V CONTACT EMAIL: bsoule • ever.reenrc.or• <br /> ' BUILDING'PERMA API!LLCATION <br /> Existing Use of Building: -R e_r 1aI- r - - ent � Contract Price of Work:$, <br /> - I <br /> Proposed Use of Building:Same Heat Source: ❑Gas BElectric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Dupieul4= ami "" rIRCommercial ❑Industrial <br /> Type of Project: :New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> Remove existing roofing and install new. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMI4 APPLICATION: PLUMBING PERMIT APPLICATION,` r <br /> Type of Project: _New Addn Alteration Repair Type of Project: __New Adds _Alteration Repair <br /> Fixtures List of Fixtures Fixtu <br /> res es List of Fixtures F.ixturfes List of Fixtures Fixtures List of 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 1Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove _Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher i Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> • <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM' <br /> Chemical or Water J No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this pen-nit 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 f comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> /1 PEROT (41 o <br /> Owner/Authorized Agent Si tore Date (Revised 9/23/2016) <br /> /2_ <br />