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SEPA 06-037 <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.# PER�IT# <br /> 10023 13th Dc SE, Everett, 98208 2805190010250 �� '� ' <br /> C� <br /> LEGAL lOTNO. BLOCK TRACT <br /> DESC. 2� <br /> OWNER ADDRESS CITYIZIP PHONE <br /> Greenfeld Park LLC 9514 4th St. NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> Brittney Lundberg 425-953-1470 x 123 <br /> CONTRACTOR ADDRESS CINIZIP PHONE <br /> Greenfield Park LLC 9514 4th SL NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> CONTR.LICENSE tt GREENPL942�2 <br /> ���1 L�,�� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Single Family Home Electric X Gas Other <br /> WORK DESCRIPTION <br /> Basic#300-1 Car Garage <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> 3 Toilet A/C—air handling units <br /> 2 Bathtub 1 Forced air systems <br /> 4 Lavatory(wash basin) 3 Gas piping <br /> 1 Shower 1 Waler heater <br /> 1 Kitchen sink 8 disposal 1 Gas freplace <br /> 1 Dishwasher Gasrange <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 heater <br /> Drinking Fountain Boiler <br /> Floor drain Re(rigeration <br /> Grease trap Woodstove <br /> 1 Roof drains Olher <br /> Olher <br /> CITY OF EVERETT L.00AL SALES TAX CODE IS 3105 I <br /> I hereby ceritity that I have read and examined this application and know lhe same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be comphed with whether specified 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 performance of <br /> construction. That I am aulhorized by the owner of lhis property to perform the work for which application is made and I comply with the <br /> i te Co tr2ctors Law 1827 R�W and 296. 00 WAC. <br /> ���1.�.�1--�, � .� � ���2�'� ����1 l�� <br /> ignature of Ownep ntraclor/Authorized Agent ,% / Date �/� <br /> � � <br />