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To: Page 2 of 3 2017-09-28 19:56:01 (GMT) '18884000383 From: Northwest Permit Inc. <br /> PERMIT APPLICATION <br /> BUILDINGiMECHANICAL/PLUMBINGISIGNiSPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERV[CES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# I � <br /> 2225 JADE AVE 00595200003300 �� _� <br /> LEGAL for ne�a construction: Short PlaUsubdivision __ _ __Lot No.__ (attach copy of long legal description) <br /> oydNERMARLYS DOVER Phone/E-rnai�425-231-2421 <br /> Address2225 JADE AVE ciry/state�zipEve�ett WA 98201 <br /> APPLICANT: _Owner _Owner's Agent __Contractor ✓ ontractor's Agent _Tenant�musi orov�ae a iec�er orconsem o-om�ne ovn,er ro ao wor;:n me spacei <br /> coNTt�acTOR HOME DEP�T USA, INC State �ic. # Ht7MED**088RH c;ty eUs. �;�.# 57001 <br /> a,dares52455 Paces Ferry Rd Atlanta 30339 pt�one�Em�i�840-381-5699 <br /> TENANT BUSINESS NAME CONTACT FOR PERM{IT <br /> Dyanna Sconzo/Northwest Permit Inc. <br /> Phone/E-mail 360-945-2787 dy@nwpermit.com <br /> BUtLDiNG PERMIT APPL[CATtON CONTRACT PRICE OF WORK 7,006.54 <br /> Existing Use of 8uilding HEAT SOURCE_ <br /> Proposed Use of Suilding Gas_ Electric_ Other_ <br /> Building type �Single Family _ Duplex_Townhouse ❑Multi-Family _ Commercial <br /> T e of ro"ect: New Addition Remodel � Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the beck): <br /> Replacing 15 squares of comp. No plywood unless found at time of install. <br /> MECHANiCAL PERMIT APPl1CATION PLUMBING PERMIT QPPLICATION <br /> Type of Project: _New_Addn _Alteratio�_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number # of fixtures Show Number # of fixtures <br /> s A1C—air handlin units ; Toilet <br /> Forced air s stems � Bathtub <br /> Gas i in. i Lavato wash basin <br /> Water heater Shower <br /> Gas iire lace ± Kitchen sink 8�dis osai <br /> i Gas ran e pishwasher <br /> j Clothes d er { Clothes washer <br /> f Ran e 3�ood Water heafer <br /> i Exhaust fan j Sink service/bar/mo /etc. <br /> i Heat um � Backflow reventer <br /> � Unit heater Urinal <br /> ; Boiler Drinkin FounEain <br /> � Refri erafion ; Floor drain <br /> Woodsfove Grease trap <br /> � Ducting i Roof drains <br /> � Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ' Other: <br /> Number of Heads � Other: <br /> 1 hereby ceitify that I f�ave read and examined this application and know the same to be true arid correct Ail provisions of laws and ordinances goveminp ihis type of work witl be compl <br /> with whether specified herein or not The granting of a permit does not presunte to give authonty io violate or cancel the provisbn of any other state or lucal law repulating construction <br /> That I am authonzed by[he owner of this property tu perform the work for which apphcaifon is made and I compry with the State Coniracturs La�v 18,ti RCW arxJ 29G,200A WAG. <br /> �yanna C`C��..�ZQ DigitallysignedbyDyanna5conzo <br /> J Dale:2017.09.28 12 54:31-07'00' <br /> Owner/Authonzed Agent Signature Date (Revised 9/2014) <br />