3209 HOYT AVE 2016-09-30 - Laserfiche WebLink

LECTRICAL PERMIT LICATION CITY OF EVERETT PERMIT v ICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E) everefteps@everettwa.gov j www.evereftwa.gov1permits PROJECT ADDRESS: 3 (� I%, ;} :v B LDING AREA(if residential,new construction,remodel,or addition) S UILD iBUILDING E.- El SFR-DETACHED 0 SFRATTACHED11 DUPLEX KMULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: - eeYdA®1 CONTRACT PRICE OF WORK:$J]96�0c) NUMBER OF DEVICES (if low voltage). FIRE ALARM? 11 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION-OFWORK: 6 FC-T 5 � <zQd� be_�,-e CO PlyORM TION OWNER NAM TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET .1crry STATE 7Jp OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME. 15- CONTRACTOR ADDRESS: STREET CI'IY STATE ZIP CONTRACTOR PHONE: � 76v Q— 1CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):cw ICITY OF EVERETT BUSINESS LIG.#(REQUIRED): PRIMARY CONTACT: 0 OWNER DrCONTRACTOR El OTHER(Please Specify) CONTACT NAME: CONTAGTPHONE: -c Cr'b C1,'rk_ I CONTACT EMAIL: AGREEMENT Thereby certify that I have read and examined this appricaffon and know the same to be true and correct. Affjorovisions of laws and ordinances governing this type of work wffbe-completed whether specified herein ornot. The granting of a permit does notprasume to give authority to violate or cancel the provisions of any other state or locallaw,regulating 001IStrUCtiOn 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 18.27RCWand 296.200 WAC. City of Everett Official Use Only FEE PERMIT# Owner/Authorized Agent Signature Uaie (Revised 1011212015)