421 85TH PL SW 2018-09-18 - Laserfiche WebLink

��,I�e//�� 1��,I��'�N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORNiAI'IARI PROJECT ADDRESS: �Pp��¢. ToN -�{Pp,2•rriqEnl;'� ya-u^ �,s� P� S�.J �v�z�7i i.,�� do�( BUILDING AREA (if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX •-r� MULTI-FAMILY-# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ��o �, u� NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES �J NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: � �,,� y �d `��,Kr �fS CONTACT INFORMATION OWNER NAME: /�J ISS/on! %�C1� Roo'2•Trt� TENANT NAME (If Commercial): OWNER MAILING ADDRESS: s-rReer GTY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CUR� F�e�r�ic- CONTRACTORADDRESS: s-rReeT ,v. o ' 3�0 CITY HIVGQ) �/ L�( STATE �ti/�- ZIP ��c�'7r� CONTRACTOR PHONE: aol�- � s--o 3 CONTRACTOR EMAIL: � �� , -{— CONTRACTOR LIC. #(REQUIRED): �� _ CITY OF EVERETT BUSINESS LIC. #(REc2UIRED): d�'J3D � ._, . .._....- .-...._.. ..._ :_.,...._. : _. _.. ... ..:... ... ...... . ..._...._.. _ ,_..._ _ ,.._ ___ _ . PRIMARY CONTACT: ❑ OWNER .�CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: aDlr ��3'!a> - � 3 Jd� P�aQ�AVL} CONTACT EMAIL: � x Q� c�E�, -_ AGREEMENT: T hereby cerfify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances govemrng fhls type of work will be completed whether specified herein or not. The g�anting of a permif does not p�esume to give authonty fo violate or cancel the provisions of any other state or local law regulating consfructron or the performance of construction. That l am aufhorized by the owner of thrs p�operfy to perform fhe wo�k for which application is made and l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Offcial Use Only FEE V.��" �`� PERMIT # E 1��p�d�� (Revised 90/12/2095)