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� . <br /> PERMIT APPLICATION <br /> CITY 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.# PERMIT# <br /> /'� —7 1 <br /> 10007 13th Dr. SE, Everett, 98208 L, .� / �� '��/ <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESQ 3� <br /> OWNER ADDRESS CITYIZIP PHONE <br /> Greenfield Park LLC 9514 4th St. NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> Brittney Lundberg 425-953-1470 x 123 <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> Greenfield Park LLC 9514 4th SL NE Suite#102 Lake Slevens, 98258 425-953-1470 <br /> CONTR.LICENSE# GREENPL942Q2 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Single Family Home _Electric X Gas_Olher <br /> WORK DESCRIPTION <br /> Basic#300 2 �F,-. ��r�,� 0�� �� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FIXTURE OR ITEM <br /> 3 Toilet A/C—air handling units <br /> 2 Bathtub 1 Forced air systems <br /> :t 3 Lavatory(wash basin) 3 Gas piping <br /> 1 Shower 1 Water heater <br /> 1 Kitchen sink 8 disposal 1 Gas fireplace <br /> 1 Dishwasher Gas range <br /> 1 Clothes washer 1 Clothes dryer <br /> Laundry tray 1 Range hood <br /> Sink(service�badmop/etc.) 6 Exhaust fan <br /> BackFlow preventer Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> Floor drain Refngeralion '�, <br /> Grease Uap Woodstove ��� <br /> Roof drains Other <br /> _ Other_ _ ' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby ceritify that I have read and examined this appticalion and know the same to be true and wrrecl All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whether speci5ed herein or not. The granting of a permit does not presume <br /> to give authority to violate or cancel ine provision of any other state or local law regulating construction or the perfortnance of <br /> construction. That I am authorized by the owner of this property to pertorm the work for which application is made and I comply with the <br /> State Cont�actors LaW 18.27 RCW and 296200 WAC. <br /> ��� ; �� � � � :'s;�� 3/�, _z <br /> SignaWre of OwnerlContractor/Authorized Agent � l Date 1/ <br /> Z <br /> – – — _ — � <br />