2109 ROCKEFELLER AVE 2016-11-07 - Laserfiche WebLink

� .. _� -- :�� . �LECT�'�iC�-�! �C�I �IT �,. ��iC;� [ E � �� 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 _ . �R0�9��`d' �1"�E IfVFORIVI/��'90P9 PROJECT ADDRESS: r I Q � � � .�.. BUILDIIVG AREA (if residential, new construction, remodel, or addifion) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ��c��c�� Lt��°�ao� ar��oa�nnArio� CONTRACT PRICE OF WORK: $ r� �� NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES ❑ NO ASSOCIATED BUILDING PERMIT # (ifi applicable): DESCRIPTION OF WORK: f� li ��j� � . , , CONTACT INFORMATION OWNER NAME: � %Y� r •� L L� TENANT NAME (If Commercial): OWNER MAILiNG ADDRESS: srReer '�7 '�� % [/'-e CITY C�/ � ( STATE ZIP U OWNER PHONE: `(�p — � V^ � OWNER EMAIL: L�'J ` {�vrtrr , s CONTRACTOR NAME: - _ � - ir � i�/� � CONTRACTOR ADDRESS: sTReer CITY STATE ZIP C�NTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(RE4UIRED): CITY OF EVERETT BUSINESS LIC. #{REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) C�NTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT.� T hereby ce�ti'ry that 1(�ave read and examined this application and know the same to 6e true and correct. Al1 provisions oflaws and ordinances goveming this type of work wifl6e completed whether specified herein ornot. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or locallav✓ regulating consfruction or the performance of consfruction. That l am authorized by the owner of fhis property fo perform the work for which applicafion is made and 1 cornply with the State Confractors Law 18.27 RCW and 296.240 WAC. rized Agent �s Date Cify of Everetf Official Use On/y FEE � �� V !�� ) ` _� PERMIT# �Il��l''�� � � (Revised 10/9?J2095)