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To: Permit Services Page 2 of 4 2016-11-16 18:54:30 (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:8111 Spokane Drive PROPERTYTAX#28050800304400 T# <br /> LEGAL for new construction. Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Filipina Neal Phone/E-mail 425-422-2243 <br /> Address8111 Spokane Drive city/state/zipEverett WA 98203 <br /> APPLICANT: Owner _Owner's Agent __Contractor ✓ ontractor's Agent _Tenant(must prov!de a letter of consent from the owner to do work in me space) <br /> CONTRACTORThe Home Depot At Home Services State Lic. # H0MED**972RQ City Bus. Lic.# <br /> Address 3600 Lind Ave SW #150, Renton 98057 Phone/Ernai1800-381-5699 <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 88114-65 <br /> Existing Use of Building HEAT SOURCE <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _ Duplex_Townhouse Multi-Family — Commercial <br /> T �e of project: New Addition Remodel Re air T.I. Sin_Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Remove and replace 17.7 squares comp. roofing. No plywood replacement. <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 1 Toilet <br /> Forced airs stems Bathtub <br /> 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 I Sink (service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> I Unit heater i Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeration Floor drain <br /> Woodstove i Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Ddi 1`.ymg-:Mby Naidal<.-s <br /> N a i d a Khan DN a--Nalda�pe o.Nodr, oa. <br /> ama.l=::^adaGnr+l �mit.mm..SUS <br /> Date:20`,6.11,1$12:05:50-0800' <br /> Owner/Authorized Agent Signature Date <br /> (Revised 9/2014) <br />