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f <br />PERMIT APPLICATION SEpAo&v37 <br />CITY OF EVERETT PERMIT SERVICES \j4A <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 <br />10003 13th Dr. SE <br />PARCEL TAX I.D. # <br />PERMIT # <br />LEGAL LOT NO. <br />DESC. 32 <br />BLOCK <br />TRACT <br />OWNER ADDRESS <br />Greenfield Park LLC 9514 4th St. NE Suite #102 <br />CITY/ZIP <br />Lake Stevens, 98258 <br />PHONE <br />425-953-1470 <br />TENANT NAME <br />CONTACT FOR PERMIT <br />Brittney Lundberg <br />PHONE <br />425-953-1470 x 123 <br />CONTRACTOR ADDRESS <br />Greenfield Park LLC 9514 4th St. NE Suite #102 <br />CONTR. LICENSE # GREENPL942Q2 <br />CITY/ZIP <br />Lake Stevens, 98258 <br />PHONE <br />425-953-1470 <br />USE OF BUILDING <br />Single Family Home <br />HEAT SOURCE <br />_ Electric X Gas _ <br />Other <br />CONTRACT PRICE OF WORK <br />�/ 1� i9f <br />WORK DESCRIPTION <br />WZW <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />3 <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />0 <br />1 <br />3 <br />1 <br />1 <br />0 <br />1 <br />1 <br />6 <br />0 <br />0 <br />0 <br />0 <br />0 <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />2 <br />1 <br />1 <br />1 <br />1 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />VIC <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing 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 perform the work for which application is made and I comply with the <br />State Cora tors Law 18.27 CW and 296.200 WAC. <br />