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; <br /> SEPA 06-037 <br /> PEFtMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADURESS ' � � PARCEL TAX I.D.# PERMIT# <br /> 70015 13th Dc SE:, Everetl, 96206 C C�7 �' 1 - � � <br /> LEC3AL LOTNO. BLOCK TRACT <br /> DESC. 29 <br /> OWNER ADDRESS CITY2IP PHONE <br /> Greenfield Park Li.0 9514 4lh SL NE Suite#102 Lake Slever�s, 98258 425-953-1470 <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> Britlney Lundberg 425-953-1470 x 123 <br /> CONTRACTOR AODr�ESS CITY2IP PHONE <br /> Greenfield Park LLG 9514 4th St. NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> CON7R.LICENSEtt GREENPL94202 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Single Family Home _Eleclric X Gas_Olher <br /> I <br /> ' WORK DESCRIPTION <br /> /�/r W �G� <br /> IBasic#300 - 1 Car Garage <br /> iPLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FI%TURE OR ITEM <br /> 3 Toilet A/C-air handling units <br /> 2 Bathtub 1 Forced air syslems <br /> 4 Lavatory(wash basin) 3 Gas piping <br /> 1 Shower 1 Water heater <br /> 7 Kitchen sink 8 disposal 1 Gas 5replace <br /> I 1 �ishwasher Gas renge <br /> i Clolhes washer i Clothes dryer <br /> Laundry tray � Range hood <br /> Sink(service/bar/moplelcJ 6 Exhaust fan <br /> BackFlow prevenler _ Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeration <br /> Grease lrap Woodslove <br /> 1 Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 9105 <br /> I hereby cerili(y that I have read and examined lhis applicalion and know the same lo be true and ccrrect. All provisions of laws and <br /> ordmaces goverNng Ihis type of work will be complied with whether specifed herein or not.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 construction or the peAormance of <br /> Iconstruction. Tha?I am authorized by the owner of this property lo pertortn the work for which applicalion is made and I comply with ihe <br /> I State Cont aelors Law 1827 FjCW and 296200 WAC. <br /> � . <br /> � � � ; � ! ,� < < � �'I����� ��� ;��r � ,t� <<� ��115/ n �� <br /> i SignaWre of OvmedCon raclodAulhonzed Agent Dat � <br /> /i� <br /> L_ __-- <br />