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) <br /> , � "�" <br /> PERMIT APPLICA�ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROPd 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# Gt <br /> 1000213thAve. SE, Everett, 98208 2805190010250D C���U—U� 1 <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. q7 <br /> OWN[R ADDRESS CIN21P PHONE <br /> Greenfield Park LLC 9514 4th St. NE Suite#102 Lake Slevens, 98258 425-953-1470 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> Brittney Lundberg 425-e53-1470 r.123 <br /> CONTRACTOR ADURESS CITY2IP PHONE <br /> Greenfield Park!LC 9514 4th Sl. NE Suite#102 Lake Stevens, 9825� 425-953-1470 � <br /> CONTR.LICENSE# GREENPL942Q2 <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Single Family Home I _Electric X Gas_Other <br /> WORK DESCRIPTION <br /> Basic#302-2 Car Garage <br /> PLUMBlf�G MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> 3 Toilel A/C—air handling units <br /> 2 Bathtub 1 Forced air systems <br /> 4 Lavalory(wash basinj GI .6 Gas p�ping <br /> 1 Shower Waler heater <br /> 1 Kitchen sink&disposal 1 Gas fireplace <br /> 1 Dishwasher Gasrange <br /> 1 Clothes washer t Clolhes dryer <br /> Laundry tray 1 Range hood <br /> Sink(service/bar/mop/etc.) (, 8' Exhaust fan <br /> BackFlow preventer _ Healpump <br /> Urinal Unit heater <br /> _ Drinking Fountain _ Boiler <br /> Floordrain _ Refrigeralion <br /> Grease lrap _ Woodstove <br /> 1 Roof drains Olher <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriti(y lhat I have read and examined this applicalion and know the same lo be true and wrrect. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or not.The granting of a permil does not presume <br /> to gioe aulhority to violate or cancel the provision of any other stale or local law regulating construclion or the perfortnance ot <br /> conslruction.That I am authorized by lhe owner of lhis property to pertortn the work for which application is made and I comply wilh the <br /> Slate Contre tors Law 1827 RCW and 296200 WAC. <br /> I�Y,YI/1 Vl ,( l,(�'10�h�/1Qr� /0"� Z"G� <br /> � nalure o�wnedC n SctodAuthonzed Agent Date �I� <br />