Laserfiche WebLink
tLLECCTR CAL PE-4,1i /11IT A.A4LICATQON <br /> _, <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 vwvw.everettwa.gov/permits <br /> PROJECT SITE INFORMATION' _ .. <br /> PROJECT ADDRESS: t 5 to ct)c..,ve,I` f -v e <br /> BUILDING AREA(if residential,new construction,remodel, or addition) 1 Li 3 SF <br /> BUILDING TYPE: ❑SFR-DETACHED eilSFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: tr--CWykaf <br /> :.:. ELECT !CAL APPLICATION INFORMATION '. <br /> CONTRACT PRICE OF WORK:$ j 0 C)T. ©o <br /> NUMBER OF DEVICES(if low voltage):, <br /> FIRE ALARM? I#1 YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): CJ 7(3 \—a2-1 <br /> DESCRIPTION OF WORK: (�I(Y1C3U� Apt) qk ',..r ` •E; SI\e �( , t4 ) G.�l�tcit- <br /> r �`p j TCi c ® Ap e✓ 6 c _s 1. 1,� ca,,,1�-H1-H <br /> x ` 55 S 5 . <br /> A-Di) g n v Dut-tse`s . Vverkode, cz,c,`rtrv‘ GA4:bcf- S <br /> coirtaer INFORMATION. <br /> OWNER NAME: r2Sy\AC l W Gt j.. TENANT NAME(If Commercial): l U k <br /> OWNER MAILING ADDRESS: MEET' 'k 5 G°3 '�.epGL�,Gp\( �-1/'�...- <br /> cfly 1..ki-cr-e4 STATE vJ A- ZIP ik2o <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ,-(_ Vuj(f <br /> CONTRACTOR ADDRESS: STREET 7 CI W-(�. <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE:(- 1S O 1*q1 _CONTRACTOR EMAIL: c,n j r31.\- 1 -‘/cSo con. <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ON OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 5-e e abew- <br /> , ' D�y�(��� 4-Due,,4 _ CONTACT EMAIL: <br /> 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 <br /> type of work mil-11,6e 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 l am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> I <br /> FEE (.' <br /> . 4 t Oa °C) <br /> 41U <br /> PERMIT# <br /> (tLe-"\-9 <br /> E noovls <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />