2128 112TH PL SE 2020-06-15 - Laserfiche WebLink

ELECTRACAL P R V17 APPLIICATIION r CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 42.5-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits (PIISOjCC�'"t-.�tl`�'C��QI�I�O.I't�dldtt'�..: ..: PROJECT ADDRESS: ,• Ds k �` t- E.J )BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED )(SFR-ATTACHED ❑DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: LL ECC 'G EIOAL APPLICATION I lINFORY IATION - - CONTRACT PRICE OF WORK:$ 7O C NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES ID NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: -- /lee() 4--(= OWNER NAME: <> ' u2 v- { c'\-ke -- t.or.1,‘cW 45 ifAlliNT NAME(If Commercial): OWNER MAILING ADDRESS: araEEr { et`jL./r'!, If)ca'A-`e 1r CrrY I (Zi r) Pt. STATE C ,,! ZIP 91-13 ` f OWNER PHONE: // 8, d >rc(,o OWNER EMAIL: CONTRACTOR NAME: '17„..w Pis L, tct 1 $e it u t ce S C SCf( /3 `1Jh AJC S ii CONTRACTOR ADDRESS: sTaEEr t ( r-�y'- CITY Ai 'eI) C.0-5 4`e STATE )) �� P f 0,5 p CONTRACTOR PHONE: CONTRACTOR EMAIL: r LCONTRACTOR LIC;#(REQUIRED): (�E(»Ka Irk-4— j- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): L414 l PRIMARY CONTACT: EI OWNER ❑CONTRACTOR a OTHER(Please Specify) Oc V\ Ge c c ,i`a^- ('p,M, CONTACT NAME: CONTACT PHONE: CT f g)- 7 Y--`f- 14-7 3 C..€/j i.4 " CONTACT EMAIL: V OU/I. 0ti ( ikC 1{ : c 6 £b 4.. AGREEMENT:T hereby cerci*that I have read and examined this application and know the same to be true and4atrect. All provisions of laws 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 l 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 alg.n9 — 005 PERMIT# 9( f-77,S/ E 2-Cr Owner/Aut..ize' d Agent Signature Date (Revised 90/92/2095)