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SEPA 06-037 <br /> PERMIT APPLICATION <br /> ('.:ITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERM(pIT# �7 <br /> 10025 13th Ave. SE, Everett, 98208 2805150010250 " t3D3 -1 / <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. qp <br /> OWNER ADDRESS CITYIZIP PHONE <br /> Greenfield Park LLC 9514 4th St. NE Suite#102 Lake Slevens, 98258 425-953-1470 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Brittney Lundberg 425-953-1470 x 123 <br /> CONTRACTOR ADORESS CITY2IP PHONE <br /> Greenfield Park LLC 9514 41h St. NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> CONTR.LICENSE# GREENPL942�2 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Single Family Home _Electric X Gas_Other <br /> WORK DESCRIPTION <br /> Basic#302-2 Car Garage <br /> PLUMBING MECHANICAI. <br /> NO. TYPE OF rIXTURE OR ITEM NO. TYPE OF FI%i URE OR ITEM <br /> 3 Toilet A/C-air handling units <br /> 2 Bathtub � Forced 2ir systems <br /> � Lavatory(wash basin) � Gas piping <br /> � Shower � Water heater <br /> � Kitchen sink 8 disposal 1 Gas 6replace <br /> 1 Dishwasher Gas range <br /> 1 Clothes washer � Clothes dryer <br /> Laundry tray � Range hood <br /> Sink(service/badmop/etc.) 6 Exhaust fan <br /> Backflow prevenier Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Retrigeration <br /> Grease trap Woodstove <br /> 1 Roof drains Other <br /> Other <br /> CITY OF EVERET7 LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know lhe same to be true and correct. Ali provisions of laws and <br /> ordinaces governing this type of work will be complied with whelher specified herein or not. The granting of a permit does nol presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the pertormance of <br /> construction. That I am authorized by the owner of this property to perform the work(or which application is made and I comply with the <br /> ��S te C�on a tors Law 18.2�.,7�'�W and 296 0 WAC. <br /> ��{,f�f ,/�G ',l-`�YI i� r��Zr� !�1 �-lC"G� <br /> nature o�OwnedCon ra, r uthonzed A ent �� Date i/? <br /> �� <br />