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SEPA 06-037 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— F AX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMI <br /> 1001713th Ave. SE, Everett, 98208 2805190070250 � �Q�- � [�D,� <br /> LEGAL LOTNO. OLOCK TRACT <br /> OESC. 42 <br /> OWNER AO�RESS CITYIZIP PHONE <br /> Greenfeld Park LLC 9514 4th St. NE Suite#102 Lake Stevens, 98256 -025-953-1470 <br /> TENANTNAME CONTACTFORPERM�T �F{�1JJ�.9�6^��n'"//� <br /> Brittney lunc'berg � 55� W� � D <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> Greenfield Park LLC 9514 4th St. NE Suite Y102 Lake Stevens, 98258 425-953-1470 <br /> CONTR.LICENSE# GREENPL942�2 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Single Family Flome Etectric X Gas Other <br /> WORK DESCRIPTION <br /> Basic#302 2 Car Garage <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> � Bathtub � Forced air systems <br /> � Lavatory(wash basin) � Gas piping <br /> � Shower Water heater <br /> ! Kitchen sink 8 disposal f Gas freplace <br /> _L Dishwasher Gas range <br /> 1 Clolhes washer � Clolhes dryer <br /> _ Laundry tray � Range hood <br /> Sink(service/badmop/etc) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> � RooFdrains Other <br /> Olher <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All orovisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or not.The granhng of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction. That I am aulhorized by the owner of this property to perform the work for which application is made and I comply with the <br /> ��St te Contrectors Law 1827 RCW and 296200 WAC. <br /> i1��r r,�;%�?�'�;��"l:��ir,��� 2' ��- �� <br /> ���5fgnat r o �vner/CoiriractodAu honzeTf Agent -T—� Date �/Z <br /> 1 <br />