4432 RIDGEMONT DR 2017-01-13 - Laserfiche WebLink

��°TRI�AL �ERIVIIi A,�L.ICAiION 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 SIiE INFORMATION PROJECT ADDRESS: %' 7 l '' �i �'�--� ,M,C;� ,j�lZ- ��/L/L�� BUILDING AREA (if residential, new construction, remodel, or addition) /�'» SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-# OF UNITS: ❑ COMMERCIAL ,n USE OF BUILDING: %(�j�/,'�,L::L-' CONTACT INFORMATION OWNER NAME: %,(� yt�s //��l�l� %CNG� TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srREET •d �G� E= CITY STATE ZIP OWNER PHONE: OWNER EMAIL: _ _. _ __ .. . _ _ .,_ _ . -.... . . . CONTRACTOR NAME: �f%��C„�� " �� - CONTRACTORADDRESS: sTReET ��Z�'� %L � �7' �L� �,/-r �T l�J� Z�P �� CITY � c-t i STATE CONTRACTOR PHONE: �/Jj - } ��k � /�� y7 CONTRACTOR EMAIL: E�/ -✓� /�C. � �-� �'�J f'. -7 CONTRACTOR LIC. #(REQUIRED): r� G � CITY OF EVERETT BUSINESS LIC. #(REQUIRED): � PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT.� T hereby ce�tify that I have read and examined this application and know the same fo be true and correct. All provisions of laws and ordinances goveming this type of work will be completed whether specified herern or not. The granting of a permif does not presume to give authonfy to violate or cancel the provisions of any other state or local law regulating construction orthe performance of construciion. That 1 am authorized by the owner of this prope�ty to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200 WAC. '; , `j ;,, � ��l,, ✓ ' 1 , Owner/Authori� d Agen Signature A ��-Z3 Il� Date City of Everett Official Use Only FEE ,� I � � � � � w PERMIT # E I ��2-� � �� (Revised 10/1?J2015)