822 CROWN DR 2016-08-05 - Laserfiche WebLink

qLECTRICAL PERMIT ,AF4 LICAT°IO N CITY OF EVERETT PERMIT SERVICES 8200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-881`0 1 FAX 425-257-8857 (E) overetteps@everettwa.gov everettwa.gc v I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: '��- � ZIVC BUILDING AREA(if residential,new construction,remodel,or BUILDING TYPE: SFR-�DETAOMED CJ SFR-ATTACHED I�DUPLEX CI MULTI-FAMILY-#OF UNITS: I1 COMMERCIAL USE OF BUILDING: EL'EOTICAL QPPL;IC.ATtQN INIrt)RMATION CONTRACT PRICE OF WORK:$ 700, CV NUMBER OF DEVICES if low voltage), : FIRE ALARM? 0 YES aNO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK; C N"M'AGT INFORMATION OWNER NAME: 4 TENANT NAME if Commercial): OWNER MAILING ADDRESS: STREET ,__,� � 01LOLZ..1 _- �. /b Gk_-CITY CITY 4�l r STATE Lfi Zip DINNER PHONE; `-t ., OWNER EMAIL: /Q.«• CONTRACTOR NAME CONTRACTOR ADDRESS: STREET &_,70 C.I tC. CITY -"ll STATE UA . zip CONTRACTOR PHONE: Zi"� ' CONTRACTOR EMAIL: -• Gl�'I ) -, i CONTRACTOR LIC.#FZEQUIRED): :(c+ a � V CITY OF EVERETT BUSINESS LIC,#REQUIRED I PRIMARY CONTACT: ❑ OWNER CONTRACTOR 0 OTHER(Please Specify) i CONTACT NAME: CONTACT PHONE: C ;�15I 50�' 0.7 L.Z_ CONTACT EMAIL:LZ AGRF.tFMF,NT,•T hereby certify that 1 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 authorify to violate or cancel the provisions of any other state or locat 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. City of Everett Official Use Only FEE f D� PERMIT# ..� I� �J r E Owner/Authorized Agent Signature Date (Revised 10112/2015) 3`3 3