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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# <br /> 420 85th PI SW 28041300200100 6,/\ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER LM Copperstone LLC Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner Owner's Agent X Contractor Contractor's Agent Tenant(rest provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Head Mechanical, Inc. State Lic,# HEADMMI912O3 City Bus.Lic.# I t <br /> Ac I drI <br /> sE. 1st Street#166 Cie Elum, WA 98922 Phone/Email 509-674-6972 TENANT BUSINESS NAME CONTACT FOR PERMITJeff Head <br /> Copperstone Apt. Homes Phone/E-mail 206-730-5178 jeff@headmechanicai.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $400 <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 of project: New Addition Remodel _Repair_T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 61,--}tvvt -elr,-,-7\ (bilk ,by: <br /> ce,1 ' - 4)1. <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(it)of fixtures Show Number(It)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems { 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 Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Goiter Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove 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 taw regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application <br /> /is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> 572 0 /! ti, <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />