5704 WEST DR 2020-04-03 - Laserfiche WebLink

HLECTR C L PERMIT AJ i-[UUCATIION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits ...,._::. .:. .. PRre)JECT SITE INF @RMATIdil •::' ;.. PROJECT ADDRESS: 5-704/ L S-r D , BUILDING AREA(if residential,new construction,remodel,or addition) &5'P_PT-i 4 SF BUILDING TYPE: krSFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: G q 2 c-2. L: • APPLICATION INFORMATION CONTRACT PRiCE OF WORK:$ lad() NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES SIO ASSOCIATED BUILDING PERMIT#(if applicable): 11 • DESCRIPTION OF WORK: /F�J i.4 L z 1372 E L - 22-o vI110vI Uv 1`L I l T ::. ... ... ...... .. . . :. . . °_: : : : CONTACT_INFORMATION- : OWNER NAME: G412 y �r i y TENANT NAME(If Commercial): l ir ;� OWNER MAILING ADDRESS: STREETf .57O� I,J1,S7 72/v cn liVV CRE TT STATE 141%- ZIP ?. ZO 3 OWNER PHONE: )&0 2Z/- 2?7F3 OWNER EMAIL:Gi9)2y oy^� �/ „ow,oPLC - c�9 c�syl.¢/ „ow,CONTRACTOR NAME: C�IV A.)E 11 / CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LiC.#(REQUIRED): W PRIMARY CONTACT: XOWNER.x 0 CONTRACTOR ❑OTHER(Please Specify) _x r CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this 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 local law regulating construction or the perfonnance of construction. That/am authorized by the owner of this properly to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 1 QC PERMIT# F 1� (D -OV_ Owner/A thori 'd Agent Signature Date (Revised 90/92/2095)