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To: E Page 2 of 3 2016-08-04 16:24:03(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: PROPERTY TAX# Adt # <br /> 6421 Cady Rd 00400000000402 , * <br /> LEGAL for new construction. Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERJoann Stremple Phone,'E-mail(425) 355-6794 <br /> Address 6421 Cady Rd City/State/Zip Everett WA 98203 <br /> APPLICANT: —owner _Owner's Agent --Contractor L6 ontractor's Agent —Tenant(must provide a letter or consent from the owner to do work In the space) <br /> CONTRACTORThe Home Depot At Home Services state Lic. # HOMED**972RQ City Bus. Lic.# <br /> Address 3600 Lind Ave SW #150, Renton 98057 Phone/Email800-381-5699 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Naida Khan/Northwest Permit Inc. <br /> Phone/E-mail 360-945-2787 naida@nwpermit.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2190.00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Building type: 77Single Family _ Duplex_Townhouse F—IMulti-Family _ Commercial <br /> Type of project: New Addition Remodel 7Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK{additional space provided on the back): <br /> Replacing 2 squares of Liberty low slope roofing and 3 squares of sheeting <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 I Toilet <br /> Forced airs stems i Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> E Gas range { Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink servicelbar/mo /etc. <br /> Heat pump Backflow preventer <br /> Unit heater i Urinal <br /> i Boiler Drinkin Fountain <br /> Refrigeration Floor drain <br /> Wood Stove I Grease trap <br /> Ducting ; Roof drains <br /> Other Medical Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM i Other: <br /> Number of Heads i Other: <br /> (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 compl <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 ar%} ,hop7edbv th r of this proVerty 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 /> L Mir 115 n 1cly s q <7 n).:ern'Icr Gavo.lo <br /> Icy p^ / DN.B JU Por c—io 0 ou, <br /> y1 d' 3 1 mal lennt D vpermll.Ism.c:rlS <br /> c D 1c.20'60 10,1:25 c1 OTOV <br /> OwnerlAuthorized Agent Signature Date (Revised 912014) <br />