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To: City of Everett Page 2 of 5 2015-08-19 22:20:00(GMT) 18884000383 From: Deborah Shields <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> *SITE ADDRESS:6909 Beverly Ln PROPERTY TAX#00393300005402 P R1114# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Constance Pierce Phone/E-maii425-263-0777 <br /> Address6909 Beverly Ln City/State/Zip Everett Wa 98203 <br /> APPLICANT:_Owner Owner's Agent —Contractor Y/contractor's Agent _Tenant(must provide a letter ofconsent from the owner to do work in the space) <br /> CONTRACTOR The Home Depot At Home Services State Lic.# HOMED**972RQ City Bus.Lic.# 042478 <br /> Address3600 Lind Ave Sw Ste 150 Renton Wa 98057 Phone/Email 800-381-5699 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Naida Khan 360-945-2787 naida©nwpermi.com <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2517.20 <br /> Existing Use of Building SFR HEAT SOURCE: <br /> Proposed Use 'iding SFR Gas_ Electric_ Other_ <br /> Building type: (Y Nagle Family _D _Tow -- e _Multi-Family _Commercial <br /> Type of project: _New Addition �2emodel repair, T.I. .Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Replace 23.7 squares of composite roofing. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration_Repair Type of Project: __New Addn Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units Toilet <br /> 1 Forced air systems Bathtub <br /> I Gas piping Lavatory (wash basin) <br /> Water heater Shower <br /> { Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler 3 Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> l Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> 3 Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp! <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and f comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Kathleen Genge n°'=EZ : t .----------- <br /> Owner/Authorized <br /> ..-. -,W- .<,.,...,,Owner/Authorized Agent Signature Date <br /> (Rev/sed 4/2015) <br />