2933 ROCKEFELLER AVE 2016-05-26 - Laserfiche WebLink

16-17 SLC C TRICA _ PIER Ji1I T 'LlICA .ON CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits . ;,22-7-`7) C _,I . PROJECT SITE INFORMATION PROJECT ADDRESS: au,e—c, z BUILDING AREA(if residential, new construction, remodel,or addition)__ _ SF BUILDING TYPE: 0 SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: PC e k1✓l cl ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES %NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: (?' (.( D / S Power g4_c,K 1- L 7 �c�r f v io f s fit pA' k o„-- ., 80 P/4,.es. CONTACT INFORMATION OWNER NAME: Oftperi,S Ob LOA. TENANT NAME(If Commercial): rya OWNER MAILING ADDRESS: STREET On Rek-ke-C 1 I-(-ed.-(-ed.- /1v� . E ere.t'�[ /6 Std 1 (11A Vc;�� CITY STATE ZAP OWNER PHONE: ifeA5-_?,(1Q — y'7 OWNER EMAIL: CONTRACTOR NAME: p u D / CONTRACTOR ADDRESS: STREET rt./e rt+ CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: /fl (\I-yell"KS 1— CONTACT PHONE: 3/9 s _ 7S 4-1_411Pi / y 77 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 performance of 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 State Contractors Law 18.27 RCW and 298.200 WAC. STtU CYC Si r,rt.�Sur �1 d S- 7s y-y5 3 City of Everett Official Use Only Ti' f}IA✓lI2- Knouts prole—� FEE �- r^C PERMIT# 4 - 7 - 9.ov5 F - d5`- Owner/Authorized Agent Signature Date (Revised 10/12/2015)