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LECT J 1C A IL PERMIT A. L CATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> -____% 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.govlpermits
<br /> P' s)JECT§1111E !INF*e:'
<br /> PROJECT ADDRESS: Ito 1 4Z "t " S 4 S E fc t\-' w at$2.0 i ^,,
<br /> BUILDING AREA(if residential,new construction,remodel, or addition) s' \ �rV
<br /> BUILDING TYPE: Dil SFR-DETACHED 0 SFR-ATTACHE w 0 DUPLEX 0 MULTI-FAMIL -#OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING: S;nl& cav": \c ��
<br /> ELEC141LAPPUUCATION IN
<br /> FORMAON
<br /> CONTRACT PRICE OF WORK: pOOO
<br /> 9°
<br /> 1
<br /> NUMBER OF DEVICES(if low v Itage):
<br /> FIRE ALARM? ❑YES krN
<br /> ASSOCIATED BUILDING PERMIT . pplicable):.
<br /> DESCRIPTION OF WORK: K.k ^e\ `!CC—kosi%' L VI� rrrl / 6 01 nen )
<br /> vvi o 14e c&.Q,4-ece Or S` y r\; 1 V/04%beeINCc,c CM— '2.a ..12_1 .
<br /> ONi" C'1',INF,OIt1111AT,1®N.'.
<br /> OWNER NAME: K;rn \G.;r Ke- d a I i TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET \\ O-) ' 1..." 5* S i
<br /> CITY ., J LFL..f STATE VJ A\ ZIP e\8Z0 3
<br /> OWNER PHONE: £KZ S)11 $-7i`IYj OWNER EMAIL:
<br /> CONTRACTOR NAME: 0 1/46kLay- C'e..(.i'r,C LLC
<br /> CONTRACTOR ADDRESS: STREET 1 K2,0 �j(31 •1v
<br /> • 1CI41 e.t. d✓ ,
<br /> CITY C-fN7.©Vtd S STATE ‘-*1‘-*1p
<br /> A ZIP 1 gv
<br /> CONTRACTOR PHONE: L.L2 Cj) 97€1-10(21 CONTRACTOR EMAIL: 34.co b 0,j\4c/eteGni c 1€v ;\ ,co
<br /> CONTRACTOR LIC.#(REQUIRED): 5C O YL rC A wL$"'i5+(3 F CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0 S St 3 t
<br /> ._�,.-.:�.,�:_,:..._,K�„.-,......,.,..,.,:.,...,,,vv,.,,,.n,.-:>..,..«...Y.............,:.....:...,,:..�:�__.-�..:,.._.,,...,"..a:.,,:..,..-..�....:,..:.,..._...,,�..,..�n:�-:.�.�,,.....�_:_-.�,�,r,�..�....._w.,.,..M>.,...:.,,x._....,:,.n_..�fi.....�.v._�.....�....._...,....,-lr�_,_..
<br /> PRIMARY CONTACT: g OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: t UZc) 3%1-19 21
<br /> �.
<br /> t,�®`eo b d te-QY CONTACT EMAIL: J u.►�D.. t vziit.e iv-, c€5w � },
<br /> AGREEMENT:T hereby certify that l have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
<br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or
<br /> local law regulating construction or the performance of construction. That!am authorized by the owner of this property to perform the work for which application is made and I
<br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> FEE
<br /> _ Ism
<br /> PERMIT#
<br /> 2 zbil F lW4 -0O (o
<br /> Owne IA orized Agent Si nature Date (Revised 10/12/2015)
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