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1 <br /> r SEPA 06-037 <br /> P�RMIT APPLIGATI�N <br /> CITY OF EVERETT PERMI�' SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADDRF_S� PARCEL TAX I.D.# P MI /#� ' / <br /> 10024 13th Dr. SE, Everett, 98208 2805190010250 � t�/�/,� <br /> LEGAL LOT N0. BLOC.K TRACT <br /> DESC. 38 <br /> OWNER ADDRESS CITY/ZIP PHUNE <br /> Greenfield Park LLC 9514 4th SL NE Suile#1C2 Lake Stevens. 98258 425-953-1470 <br /> TENANiNAME CONTACTFORPERMIT PHONE I <br /> Briitney Lundberg 425-953-1470 x 123 I <br /> CONTRACTOR AODRESS CITYIZIP PHONE <br /> Greenfield Park LLC 9514 4th St. NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> CONTR.LICENSE# GREENPL942Q2 <br /> USE UF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Single Family Home _Eleclric X Gas_Other <br /> WORK DESCR�P'i ION <br /> Basic#302-2 Car Garage <br /> PLUMBING MECFiANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> 3 Toitet A/C-air handling units <br /> 2 BalhWb � Forced air systems <br /> � Lavatory(wash basin) —� Gas piping <br /> � Shower � Water heater <br /> � Kitchen sink&disposal � Gas fireplace � <br /> 1 Dishwasher Gas range <br /> 1 Clothes washer 1 Clothes dryer <br /> _ Laundry tray 1 Range hood I <br /> Sink(serviceNadmop/etc.) 6 Exhaust fan . <br /> _ Backflow preventer _ Heat pump I <br /> . Urinal Unit heater <br /> Drinkiny Fountain Boiler �� <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> 1 Roof drains Other <br /> Other <br /> ICIN OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of 12ws and <br /> ordinaces goveming this type of work will be complied 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 authorized by the owner of this property to pertorm the work for which application is made and i comply with the � <br /> ��Co lir�aL�8�2~',I�� �Z4'�l�����t'" fl � � nC/ <br /> � � � � <br /> �Sig ature of OwnedCbntractof Authorize�Agent i' , Date tl� <br /> U � <br />