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F'E�CMIT APPLICATION SEPA06-037 <br /> CITY OF EVERETT PERPJIiT SEkVICES <br /> 3200 CEDAR STREET, EVERET�, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATION� AFE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 10009 13th Ave. �E, Everr.tt, 98208 ?f305190010250 � ��Q� —po3 <br /> LEGNL LOTNO. BLOCK TRACT <br /> DESC. 44 <br /> OWNER ADDRESS CITY2IP PHONE I <br /> Greenfield Park LLC 9574 4th St. NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Brittney Lundberg 425-953-1470 x 123 <br /> CONTRACTOR ADDRESS CITYIZIP PHONE <br /> Green6eld Park LLC 9514 4th SL NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> CONTR.LICENSE X GREENPL942Q2 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF JVORK <br /> Single Family Home _Electric X Gas_Other <br /> WORK DESCRIPTION <br /> New iiouse-Basic#302-2 Car <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> � Toilet A/C—air handling units <br /> � Bathtub T Forced air systems <br /> � Lavatory(wash basin) 1�� Gas piping <br /> Shower Water heater <br /> � Kitchen sink&disposal / Gas freplace I <br /> � Dishwasher _J___ Gas range <br /> � Clothes washer _/__ Cbthes dryer I <br /> _ Laundry tray � Range hood � <br /> Snk(service/badmop/etc.) � Exhaust(an �� <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> � Roof drains _ Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> I hereby cerifify thal I have read and examined this applicatien and know the same to be true and wrrect All provisions of laws and 'i <br /> ordinaces goveming ihis type of work will be complied with whether specified herein or noL The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating conslruction or the perfonnance of <br /> construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> ,�tate Contractors Law 18 7 jtCW and 296200 WAC. <br /> �� ;�' ;���%��.�(, l-� �,-, 1�--3J-b�- j <br /> Sig a�re of Owner o tractor Auth nzed Ager}� Date <br /> ( ; `�Z <br />