Laserfiche WebLink
ELECTI\MAIL PER MT APPLICATION <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 www.everettwa.gov/permits <br /> PROJECT SITE!INFORMATION <br /> PROJECT ADDRESS: 1.552.s. <br /> BUILDING AREA AREA(If residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: El SFR-DETACHED 0 SFR-ATTACHED El DUPLEX El MULT1-FAMILY #OF UNITS: OMMERCIAL <br /> USE OF BUILDING: <br /> . , <br /> IIA". <br /> ELECT-MAL APPLOCATIION INFORMATIV 4\1 <br /> CONTRACT PRICE OF WORK:$ 30 0 efre;) <br /> NUMBER OF DEVICES(If low voltap): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> DESCRIPTION OF WORK: r ot...shie-Cr CJig .").1 Fat_. 1-Z-ft(/' <br /> RGO-k,ALG: (3S T-1,-314k.c-(-41- <br /> . , . <br /> • CONTACT INFORMATION • • • • — • ' <br /> . . <br /> OWNER NAME: g,z1zerr c.„,„. NANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET Z132c2 (4 tv-j)17. A <br /> CITY Lk)OaeL L STATE 1...4 1-fFt)( <br /> OWNER PHONE: Alr4 JOWNER EMAIL: <br /> CONTRACTOR NAME: 'Cc> 1‹. <br /> CONTRACTOR ADDRESS: STREE T SI 20 re4C"..t4-c- <br /> cm( afewri STATE (..kAk. 2IP ncr. <br /> CONTRACTOR PHONE(lal 4 --31/9 CONTRACTOR EMAIL: <br /> CONTRACTOR Lie.#(REQUIRED): ,15:erZO PA) CITY OF EVERETT BUSINESS LIC.#(REQUIRED 05 <br /> PRIMARY CONTACT: El OWNER VI:CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACTNAME: CONTACT PHONE: lf ,., 2., 2— (/9- <br /> 4- Sk 1.0 CONTACT EMAIL: 6e.jez.,ZrOjeK <br /> AGREEMENT:I hereby certify the!1 have read and examined this application and know the some to be(rue and correct. All provisions of laws and ordinances governing this type <br /> of work will be completed whether-speckled heroin or not. The granting of a permit does net presume to give authority to violate or cancel the provisions of any Wu:4.state or <br /> local taw regulating construction or the performance of constniction. That lam 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 ROW and 296.200 WAG. <br /> City of Everett Official Use Only <br /> ". PERMIT# <br /> • 2.6 E EDO 3 0 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />