5112 DELAWARE AVE 2017-04-19 - Laserfiche WebLink

_LEGTRICAL PERMIT tm :�- PUCATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov 1 www.everettwa.gov1permits M pm, �q Ak "Imp- 41T. PROJECT ADDRESS: 5 Lo BUILDING AREA(if residential, new construction,remodel,or addition) 400 SF BUILDING TYPE: 0 SFR-DETACHED U9 SFR-ATTACHED EIDUPLEX ❑MULTI-FAMILY-#OF UNITS- El COMMERCIAL USE OF BUILDING: ORM CONTRACT PRICE OF WORK: NUMBER OF DEVICES (if low voltage). FIRE ALARM? El YES 1p�NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION-OF WORK: etpo io OWNER NAME"':`.' \/gj__ Atr_t,>j TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET C V L_ CITY STATE \k)A zip • OWNER PHONE: ZU0 11G OWNER EMAIL; ID-rcerf.Ja r)d ep w; I t (& e7m - 00MA CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE zip CONTRACTOR CONTRACTOR PHONE; EMAIL: CONTRACTOR LIC.#(REQUIRED): ICITY OF EVERETT BUSINESS LIC.#(REQUIRED)- PRIMARY CONTACT: I�LOWNER 000NTRACTOR El OTHER(Please Specify) CONTACT NAME: CONTACTPHONE: Vol4erotlt CONTACT EMAIL: AGREEMENT T hereby certify that I have read and 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 I 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 Evereft official Use Only FEE [PERMIT# I E F] (Revised 1011212015)