4328 FOREST DR 2021-12-14 - Laserfiche WebLink

LL CT( RIC AL PERMIT 4PLICATION CITY OF EVERETT PERMIRVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov www.everettwa.gov/permits PkOJPCT SY 'E llli�I1Rlfl `�I � PROJECT ADDRESS: 3 Fore BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑SFR ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: t e0lt Pp EEGT APPLI.0-A CONTRACT PRICE OF WORK: NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT#Cif applicable): DESCRIPTION OF WORK: +e*n CONTACT-.IhiFORMATION ;.:: ,._: ;:._• .. = Q7NNER NAME:: (�� Q.' TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET CPy STATE ZIP OWNER PHONE: 2S 3�� C� OWNER EMAIL: CONTRACTOR NAME: clark ,5 CONTRACTOR ADDRESS: STREEr �+ CITYY5 STATE ��r J zip CONTRACTOR PHONE: 2�i'7(p//G,,(— [j /�L CONyTR�ACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): Ct A�_�_ 3 o( 1j<"(yI CITY OF EVERETT 13USINESS LIC,#(REQUIRED): PRIMARY CONTACT:m Cl OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: j-q 7�G_ C`/ CONTACT EMAIL: AGREEMENT.'Thereby 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 ornoL The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regula ft construction orthe performance of construction. That/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 5� PERMIT# E owner/Authorized Agent Signature Date (Revised 10/12/2015)