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; <br /> � P�RMIT APPLICATION SEPA06-037 <br /> CI�'Y l^�F EVERET�' PE:RMIT iEl2VICE� <br /> 320D CEUAR STRLET, EVERETT, V�A 93201 <br /> 425-257-3810 -FAX 425-257-8857-�vww.everettwa.org <br /> APPLIC:.4TIONS ARE ACCEPTED FR0117 8 AM TO 4 PM � <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 10012 13th Dr. 3E, EoeretL 99206 _��O ���1—OQ�� <br /> LEGAI. LOT NO. BLOCK TRACT <br /> ' D[SG( 35 �_ <br /> OWNEk ADDRESS CITY/ZIP F710NE <br /> Greenfield Park LLC 9514 4th St NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> iBri�tr,ey Lundberg 425-953-7470 x 123 <br /> � CONTRACTOR ADDRESS CITY/ZIP PHONE � <br /> Greenfeld Park LLC 9514 41h St NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> iCON7R.uCENSett GREENPL942a2 <br /> I USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK i <br /> Single Family Home Eledric X Gas Other ' <br /> — — — I <br /> WORK DESCRIPTION I <br /> � <br /> Basic#302-2 Car � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FI%TURE OR ITEM <br /> 3 Toilet A/C—air handling uni�s <br /> 2 Bathtub 1 Forced air systems <br /> 4 Lavalory(wash basin) �� Gas piping <br /> 1 Shower 1 Water healer <br /> 1 Kitchen sink&disposal 1 Gas fireplace <br /> � Dishwasher Gas range <br /> 1 Clothes washer 1 Clothes dryer <br /> Laundry tray � Range hood � <br /> Sink(service/barimop/etc.) (� Exhaust fan ! <br /> Backflow preventer Heat pump � <br /> Urinal L'nit heater I <br /> Drinking Founlain 8oiler <br /> Floor drain Refrigeralion <br /> Grease hap Woodstove <br /> 1 Roof drains Other � <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS 3105 I <br /> I hereby ceriti(y that I have read and examined this application and know the same lo be true and correcL All provisions of laws and I <br /> ordinaces governing this type of work will be complied with whether speci6ed herein or noL The granting of a permit does not presume , <br />. to give authoriry to violate or cancel lhe provision of any other stale or local law regulating conslruction or the performance of i <br /> conslruction. That I am authorized by the owner of this property to perform lhe work for which application is made and I comply with the � <br /> State Con�ractors Law 1827 RCW and 296200 W.4C. . <br /> � ^ , 1 <br /> � f1 1i ( i l�� , � ' (0 � ` i <br /> Signatu e ot Own—` er/CoAfractbdAuth dzed Agent,� Dat <br /> / I � ��Z <br />