11223 19TH AVE SE VIVA NOODLES 2018-08-13

'LCC R CAL PERMIT G IPLUCCATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits 'ROJ CT SRTE intilfIATIOPd PROJECT ADDRESS: /l2 2 3 /9 ,re S BUILDING AREA(if residential, new construction, remodel,or addition) SF �� BUILDING TYPE: 1:1 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: 5 � ELECTRICAL PPLICt TI t©RI Ii\IFORIVIATI •l CONTRACT PRICE OF WORK: $ //; Del •NUMBER OF DEVICES (if low voltage): FIRE ALARM? OYES Arts'10 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: /l -217-174a/6, E-L+t'E 1Lt U c e'vi-e& av2_, e G�C�o� if dCrr-72N d 6 /�ef� �P� vie-47 �"P /Z i�2 /e/ � er vz-e-es I7 e• t i ,� v C nor e� . ane l- -479 �i h ($e/ Vic< S Q-4-1/ CONTACT INFORMATION • OWNER NAME: Y// Aae,_ 7 TENANT NAME(If Commercial): i: dCifJt,Q LL < 6-.77&171 OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: 2 o‘ g3 Z yzz p OWNER EMAIL: ,s--;2,4,,i-e,_44-2.e7..."-e-9,42_ WSJ ,yyl ' CONTRACTOR NAME: ''C+ J 2 // a� ZZ e CONTRACTOR ADDRESS: STREET 9 :z% v 3a 72- CITY 2CITY Lc/i'r /e0 STATE /d ZIP CONTRACTOR PHONE: 266 ? .q? /'4 Z CONTRACTOR EMAIL: S'CO- jj,lee /--rcIle 47 0, •& t CONTRACTOR LIC.#(REQUIRED): L5C1P7 7-/E. $z CITY OF EVERETT BUSINESS LIC,#(R UIRED): .•, r PRIMARY CONTACT: OWNER ❑ CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: EL-9 9 i c S 441, t- 7 f CONTACT EMAIL: �e— �j a AGREEMENT::T hereby certify that l have read d examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That l 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 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE Lis .c� r PERMIT if — — — _4010 iv/ Owner/Authorized Agent Signature Date (Revised 10/12/2015)