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SITE ADDRESS <br />2415 Belmonte Lane <br />LEGA LOTNO. <br />DESC. Zy <br />Belmcnte Heights LLC <br />TENANTNAME <br />CONTRACTOR <br />Belmonte Heights LLC <br />CONTR. LICENSE p <br />0 <br />PERMIT APPL�CATION <br />CITY QF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257•8810 — FAX 42n•257-6857 — ww��i.evaretiwa.or� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PA I <br />BLOCK <br />BELMOHL94460 <br />USE OF BUILDING <br />WORK DESCflIPTION <br />Basic # 206 <br />N0. I TVPE OF FIXTURE OR fTEM <br />__�__ Toilcl <br />2 6alh�ub <br />4 Lavatory (wash basin) <br />1 _ Shower <br />1 Ki�clian sink 8 cispos�l <br />1 Dishwasher <br />_ �1. Clolhes washer <br />Water heater <br />___ Sink�,ervice'barnnoU'elc.) <br />___ �ack�law pievenler <br />Urinal <br />_ _ Drinking Fountain <br />f"loor drain <br />, _ Grcase Irap <br />Rool drains <br />O�her <br />PARCEL TAX I.D. # <br />010640-OOG•029-00 <br />TAACT OH SUBDIVISION N <br />PERMIT # <br />9514 4th St. NE Suite #102 Lake Stevens, 98250 425953•7470 <br />CONTACT FOR PERMIT NHONE <br />Z <br />Brittney Lundberg 425-953•7470 x123 <br />AOIIRF.SS CITY2IP PHONE <br />9574 4th St NE Suile #102 Lake Stevens. 98258 425-953-7470 <br />HEATSOURCE <br />Electric X Gas Other <br />CONTRACT PRICH OF WOflK <br />N0. I TYP'e OF FII(TURE OR ITEM <br />A/C – air handling units <br />t Forced air systems <br />4 Gas piping <br />1 Water heater <br />1 Gas fireplace <br />1 Gas range <br />1 Clothes dryer <br />1 Range hood <br />5 Ezhausllan <br />_ Heat pump <br />Uni1 heater <br />Boiler <br />Refrigriralion <br />Woodstove <br />Othe� <br />CITY OF EVERETT LOCAL SALES TA% CODE IS �105 <br />I he,eby cerilify �hat I have read and examined ihis applicalion and know the came to be true and correcl. All provisions ol laws and <br />ordinaces goveming Uiis lype of work will be complied with whelher specified he�ein or not. The grenting ol a F�rmit does not presume <br />to give authorily to violate or cancel Ihe provision ol any o�hor state oi local law regu�ating construction or ihe porlormance ol <br />construclion. Thal I�m authorized by Ihe owner ol this property lo pertorm �he work Iw which applica�ion is made and I comply wilh �he <br />Stale 0 tr ctors Laa�18 7 RCW a d 296200 WAC. <br />( i � , ) ,�t/1 �-� � I � � <br />Il��� � ���� � ' � �� <br />ignature of wqer/ ont actor�Aut orized Ag l5ate <br />� � 7� <br />� ' <br />