1011 93RD ST SW 2020-06-19 - Laserfiche WebLink

"11111°P' LECCTRIICCAL PERTALIICATIION rCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJIECT M11Th ORIFOI; G dAT1ONY: PROJECT ADDRESS: JO? i /- sit-, T 7.� `7�1i� �ilQ/}�c ' ,. l:�/J1 9 5 �-ci CC BUILDING AREA(if residential,new construction,remodel, or addition) / I CO--0 SF BUILDING TYPE: D SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: - F I 0OT'IR1O:I.G PPL6dATI Hal 11N F`OF' �A '1O CONTRACT PRICE OF WORK:$ /)d 0 , ---') NUMBER OF DEVICES (if low voltage):, FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable):'W abS--'00.1 DESCRIPTION OF WORK: l.4yy�A YIL / LL,II1 `\ - SI'k-,. ,r7Y LM • ` ?Lit-L-- 'YV_(v(trio SeY v"c CP G a 14 OC /(L,ted :_vyc-, Q.(,( `1'4 .. . - CONTACT INF 0.RMAT1ON _ I OWNER NAME: \,/, IAN/AL.(y C 1,(Q- }.1 ,TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 10`% i _1 L�f ji ' cir( --="kA or-Ori STATE (.A/A- ZIP c 'S 2.-,. ., OWNER PHONE: La '711 9<- 7 �l U OWNER EMAIL: \f�9Vt'N�:i rCA461 .Cli '1CC&4.- vel 0:4 CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET ' CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: ' CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: d OWNER 0 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 I am authorized by the owner of this properly to perform the work for which application is made and l comply with the State Contractors Law 16.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 4- I • ., vw_---- PERMIT# (7/./6/, - 7 Own�rl uthorizedAgentSignature Date ' (Revised 10/12/2015)