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To: Permit Department Page 2 of 4 2016-06-01 01:47:43 (GMT) 18884000383 From: Deborah Shields <br /> 0 0 <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:8717 10th Dr SE PROPERTY TAX#00801300001 300 PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERAdhanom Teclehaimanot Phone/E-mail206-306-5469 <br /> Address 8717 10th Dr SE City/State/zipEverett WA 98201 <br /> APPLICANT: Owner _Owner's Agent __Contractor - ontractor's Agent _Tenant(must provide a letterof consent from the owner to do worK in the space) <br /> CONTRACTORThe Home Depot At Home Services State Lic. # HOMED**972RQ City Bus. Lic.# Q ?"(15 <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 812,128.18 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Usetllding Gas Electric Other <br /> Building type: 2V( Single Family _ Duplex_Townhouse Multi-Family — Commercial <br /> T Y e of ro'ect: 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 25 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 Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater I 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 <br /> i Unit heater Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> I <br /> Number of Heads i Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.AN 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 29g.200A WAC. <br /> a a Did ty ai�nM by Noida Khan <br /> N a I d a Khan , DN:c-�•Naitla Khan,o•Nerlh��,est Pormlt Inc.. <br /> �.amal=nada({.nvnse:miL,xim,�ll5 <br /> Datc:20'6.05.31'8aG20-07V0' <br /> Owner/Authorized Agent Signature Date <br /> (Revised 9/2014) <br />