11030 EVERGREEN WAY 2016-10-20 - Laserfiche WebLink

08/12/2016 FRI 8: 44 FAX 425 252 1666 CM Heating U015/031 RECTRICAL PERMIT AILICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425257-8810 FAX 425-257-8857 1 (E) everetteps(Meverettwa.gov I www,everettwa.gov/permits , ", • \.puil;cl lL,r,,+'� .,,,,t,, it;;r r..,�.,��;�;., ,• 1 ��+E+' PRO� rC Y $,1T1!"1 N FO I_1VI.d!1�' }�• „i " PROJECT ADDRESS: Re-C, BUILDING AREA If rosldentlal,new construe , remodel, or addition) SF BUILDING TYPE; ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ULTI-FAMILY-#OF UNITS: ( } ❑ COMMERCIAL USE OF BUILDING: T11i �►L 1ppLICF#TION',INFORM N 'kIGIN CONTRACT PRICE OF WORK: $ d NUMBER OF DEVICES If IOW VOILa e : FIRE ALARM? ❑YES ❑ NO ASSOCIATED BIJILDIN0 PERMIT# If applicable): DESCRIPTION OFWORK: CONTACT INFORMATION OWNER NAME: TENANT NAME If Commerclal : J OWNER MAILINQ ADDRESS: STREET I L ff CITY STATE ZIP OWNER PHONE: WT OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS; STREET "1 ( CITY OTATE ZIP i'CJ l CONTRACTOR PHONE: CONTRACTOR EMAIL: + , CONTRACTOR LIC,#REQUIRED : CITY OF EVERETT BUSINESS LIC,#(REQUIRED: �Qt� PRIMARY CONTACT: ❑ OWNER ONTRACTOR ❑ OTHER(Please Spaclfy) CONTACT AM CONTACT PHONE I 5" �m CONTACT EMAIL; ¢ '(0 rn AGREEMENT,Thereby certify that I have reed and examined this appilcwlon and know the same to be true and correct. All provisions oflaw$and ordinances governing this type of work will by completed whether specified herein or not. The granting of a patm)t does not presume to give authority to violate or cancel the provisions of any other stele or local law regulating conalrucHvn or the performenoe Of consfructicn, That 1 em aufhorizad by the owner of thfs property to potform the work for which applloatlon Is made and I comply with the Slate Contractors Law 18.27 RCW and 298.200 WAC, City of Everett Officigl(Joe only FEE PERMIT 0 \ E OwnerlAu horizod Agent 91unature Det (Revised 10/97,12015)