Laserfiche WebLink
���c������ ������r ���ic��io�v <br /> C1TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 , (E) everetteps@everettwa.gov � wvvw.evere�twa.gov/permits <br /> PR+I�JECT SI'fE INFORhrIA"�"10N <br /> PROJECTADDRESS: �32,� �;p(,jp V� <br /> BUILDING AREA(if residential, new ccnstruction, remodel, or addition) g� <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-A7TACHED ❑ DUPLEX ❑ MULTI-FAMILY-�OF UNITS: COM1�tERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CON7RACT PRICE OF WORK: $ � �,ao <br /> NUMBER�F DEVECES (if low voitage : <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: $� �r � � <br /> r C� � !c <br /> CONTACT INFORMATION <br /> OWNER NAME: �C'�+;�e�.�>ttt.. �-;4..�„��t :�' ` TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srRcEr <br /> crrv <br /> STATE ZP <br /> OWNER PHONE: OWNER EMAfL: <br /> _. <br /> _. . .. <br /> CONTRACTOR NAME: V�� �(�M�(� <br /> CONTRACTOR ADDRESS: Sr�E�r '�(� �L,�(� � <br /> crn -�}�(i.,. srAre (1ti%� ��;(Z>�: <br /> Z�P <br /> CONTRACTOR PHONE: '�G�, -'=(�G:� 7 ZLC CONTRAC70R EMAIL: <br /> CONTRACTOR LIC.#(REqUiRED) V�(,r{�����Z �,'� C1TY OF EVERETT BUSINESS LIC.#(REQUIRtD):C���(�f� <br /> ._..---._ ..._.. . .,_„ <br /> _ _ ....__. . <br /> ..,... _.._.._.. _...:_ <br /> _.,..... _..,_.._ ....._.. <br /> PRIMARY CONTACT: ❑OWNER _. ,. ...:.,._.._ ..:._. ...._._.�..:.._ .- <br /> �CONTR.4CTOR C7 OTHER(Pfease Specify) <br /> GONTACT NAME: GONTACT PHONE: -7 • <br /> �^ „V LU(,�- �j.r?�'i',.�2 ...� <br /> i�� J <br /> ���i c..�.`.�"i_��..�'i,L���C9i, CONTACTEMAIL: ,�+.�r.'",i�Iw �i�'i;Gciw�'�u,� `� <br /> � ���.c�r� <br /> AGR�FTntNT•T i�e�epy certify that l have;ead and examrred fhrs appiicaticn and kno�✓�the same to be frue and correct AN provisicns of/av✓s and ordina.�ces govem,ing this <br /> ypa of 4vork v�il!ba complef2d wheth.er soecifi2d h�rein or not. The gran.;ng of a permit da�s not presume to oive authority to violate or cance/the proi�fsrcns of a,oy other sta:`e or <br /> loca!la:v regurating consirvcficn or the performance of construction. Traf/2m 2uthorized by the ormer o;fhis prope�y to perfo�m the vror',c for which 2ppiication is made and i <br /> compiy miith the State Cor,trzctois Law 18.27 RCW ar,d 296.200 VVqC. <br /> Ci"ry of Everett Oificiai Use Or,ly <br /> FEE �—� <br /> � ( �, a - � v <br /> PERMIT# <br /> � � 321� E 910 � �bl � <br /> nerlAut rizedAgentSignafure ie <br /> (Revised 10/12/2015) <br />