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To: Permit Department Page 2 of 4 2016-08-19 02:35:12 (GMT) 18884000383 From: Deborah Shields <br /> • • <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:8708 1 Oth Dr SE PROPERTY TAX#00801300000500 P T# <br /> LEGAL for new construction: Short Platisubdivision —Lot No. (attach copy of long legal description) <br /> OWNER Ron Tagle Phone.E-mail(425) 879-3272 <br /> Address 8708 1 Oth Dr SE City/State/zip Everett WA 98208 <br /> APPLICANT: Owner _Owner's Agent __Contractor ✓ ontractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTORThe Home Depot At Home Services state Lic. # HOMED"972RO 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 S12,325.13 <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 /> Type ofproject: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Remove and replace 28.7 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 i Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clothes dryer j Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump IBackflow preventer <br /> i Unit heater Urinal <br /> i Boiler Drinking Fountain <br /> Refrigeration <br /> i Floor drain <br /> Woodstove Grease trap <br /> j <br /> Ducting Roof drains <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads I Other: <br /> I hereby certlly 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 1 am authorized by the owner of this prop�ert to perfomt the work for which application is made and I comply with the State contractors Law 18.27 RCW and 296.200A WAC. <br /> Ddr ty rOr,�C b)'haiUa Kh.^n <br /> Naida Khan ON°n-Nalda Khan,o•No lh wst Pormlt Inc.ov, <br /> �smaihnaida(;fnv.Permit•xm,o•lJ5 <br /> Date:2016.08.16 19:32:06-07V0' <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />