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1 <br /> PERMIT APPLICATION SEPA06-037 <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 /> 1002013th Dr. SE, Everett, 98208 2805790010250 �0�� � � b�z , <br /> LEGAL LOTNO. BLOCK TRACT ' <br /> DESc. 37 � <br /> OWNER ADORESS CITY2IP PHONE I <br /> Greenfield Park LLC 9514 4th St NE Suite#102 Lake Stevens, 98258 425-953-1470 �! <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> Brittney Lundberg 425-953-1470 x 123 <br /> CONTP.ACTOR ADDRESS CITYIZIP PHONE I <br /> Greenfeld Park LLC 9514 41h St. NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> CONTR.LICENSE# GREENPL942Q2 <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Single Famity Home Electric X Gas Other <br /> WORK DESCRIPTION <br /> New House-Basic#302-2 Car <br /> PLUMBING MECHANICAL <br /> NO. 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 = Gas freplace <br /> � Dishwasher I Gasrange <br /> � Clothes washer � Clothes dryer <br /> Laundry tray �_ Range hood <br /> _ Sink(servicelbadmopfelc.) i"� Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unil heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> � Roof drains _ Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> I hereby ceritify that I have read and examined this application and know lhe same to be hue and correct. All provisions of laws and <br /> ordinaces governing this type of work will be comptied with whether specified herein or not The granting of a permit does not presume <br /> to give aulhoriry to violate or cancel the provision of any olher state or local law regulating construction or the performance of <br /> construction.That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State Co tractors Law 1��7 RCW and 296.200 W.4C. <br /> ��-I <br /> ��:�, ;�,f�.Gvt'�� � �� c(G�.P��.�, , /? - � /-U� <br /> Signatureof wner/CorRract�/Autho�zetlAgent,. / DatO ��j <br /> J J � <br />