1121 SE EVERETT MALL WAY SNOPAC 2017-04-20

Feb, 4, 2016 8: 50AM No. 3552 P. 1/1 'LEGTR ICAL PERMIT APPLICATION�141� � - CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.evereltwa,gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1121 5E Evece-q- malt t o Zoo BUILDING AREA(if residential,new construction,remodel,or addition) N/A SF BUILDING TYPE: D SFR-DETACHED ❑SFR-ATTACHED D.DUPLEX 0 MULTI-FAMILY-#OF UNITS: 1.COMMERCIAL USE OF BUILDING: CPI Gene( (SOOpae , (�►CQMi(1� -----..-.. --- --ELZ:i'1YCL Apff ►TION INFUMAT1 ... ,... . . • CONTRACT PRICE OF WORK:$ 2 3 Co L' .00 NUMBER OF DEVICES(if low voltage): L'Q FIRE ALARM? DYES ANO ASSOCIATED BUILDING PERMIT#(if applicable); , f I nn DESCRIPTION OF WORK: Rech ave_At reP(GCe Lk 1;Ke in-i Ind 12v 1;a+f"^erteS to ups (abe'r. 0 e.erake, ba4fecy cdiscom,e* 6ceu leer before 4-Prat install_ CONTACT INFORMATION OWNER NAME: Gy1-1/1 0c Evece-k* TENANT NAME(IF Commercial): S(\(3PRC Aem►r OWNER MAILING ADDRESS: STREEr 2_2O o Cedar 6{ 0/TY Fv e.re k sum U A ZIP q8?.o I OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: e ne rs y A De.IaWRC-e .(n C CONTRACTOR ADDRESS: STREET I 14323 82nd 5+. E Q Q ct'Y -SLUM e C STATE WA ZIP 92 3 /o CONTRACTOR PHONE: 2S3-299- 0o06 . CONTRACTOR EMAIL: re me ccce, Fia Na9ac&gflersys.co M CONTRACTOR LIC-#(REQUIRED): G'N RS bi,89 1 09 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O2°%M O PRIMARY CONTACT: ❑OWNER DKCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:Terrence (-1A naSan CONTACT PHONE: 3600-9,g_618 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 wilt 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 t comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE • t5.4/- PERMIT# 2- Co E IO2-021-4 Owner/Authori d Agen Signature Data (Revised 90/72/2095)