714 110TH PL SE 2017-06-07 - Laserfiche WebLink

F 116-1XIVI I I r.%$ a — fr-%a 1,%,*v CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INS PROJECT ADDRESS: BUILDING AREA(if residential,new construction.remodel,or addition) SF ..-1 BUILDING TYPE: 0 SFR-DETACHED V_SFR-ATTACHED 13 DUPLEX 0 MULTI-FAMILY-4 OF UNITS 0 COMMERCIAL IUSE OF BUILDING: ELECTRICAL APPLICATION. INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: ............. con OWNER NAME: TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET /D'C- CITY SIATE 7P OWNER PHONE: ]OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: scene r CITN V\I— SWE ZIP TCONTRACTOR EMAIL:CONTRACTOR PHONE: _R EMAIL CONTRACTOR LIC.#(REQUIRED):i��Kr�t—*3z"-,Y—<f ICITY OF EVERETT BUSINESS LIC,#(REQUIRE D):C)S�bf;�,lj ............... PRIMARY CONTACT; 0 OWNER A CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME- I CONTACT PHONE: 210-�710E ICONTACT EMAIL: Y\.Q - AGREEMENT,7,hereby codify that l 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 bc completed whether sPocifiod herein or not. The granting of a permit(toes not presume to give a0horfY to violate or cancel the proWsluns of any other state or local taw regulating constevcoon or the performance ofoonafruchon. That I am authorized by the owner of this property to perform the work for which application is niade and i comply with the State Contractors Low 18.27RCWand 296.200WAC. City of Everett Official Use Only OX-4ve— '_-��K- 0Nq_WA- FEE PERMIT# "'E Oq er/Authoriz Sign Date (Revised 1011212015)