7910 FOREST GLADE 2020-06-16 - Laserfiche WebLink

(ref, L_EC1fRCALP- ERMIT( AFii-JCATION Err CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 (E) everetteps@everettwa.gov I www.everettwa.gov/permits • IP ®JEECT SITE 1111F0I• dC �lloOw,: PROJECT ADDRESS: -7c),c9 67pa_ BUILDING AREA(if residential,new construction,remodel,or addition) 9(90 SF BUILDING TYPE: 2SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: 7A-- . ELECTRICAL APPLICATI1O 'CONTRACT PRICE OF WORK:$ ( 5 NUMBER OF DEVICES(if low voltage): !FIRE ALARM? ❑YES 4Eris10 ASSOCIATED BUILDING PERMIT#(if applicable): C- l.46O ' 7d 'DESCRIPTION OF WORK: CO✓ alai-t f 1 CONT'CT ONF®A4t ATIOtl9 OWNER NAME: '.:\f"" CO Vee (If Commercial): ) t TENANT NAME : OWQpr OWNER MAILING ADDRESS: STREET �,tQ 25't#- (j(w- - VIA— CITY Z+�r STATE ZIP OWNER PHONE: N Z Lt - 55 7 OWNER EMAIL: C dv ec e-1 ow, mcI r.c D t",, CONTRACTOR NAME: JCS CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: • CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: jCl OWNER ❑CONTRACTOR 0 OTHER(Please Specify) 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 performance of construction. That l 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 296.200 WAC. City of Everett Official Use Only FEE 11 PERMIT# (gftilie E Owner/Authorized Agent Signature Date (Revised 10/12/2015