2108 HOYT AVE 2017-06-13 - Laserfiche WebLink

CITY OF EVERETT PERMITS ERMIT ICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 ] (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT Sl'1[E IMFO)FtIVIAT10Ri PROJECT ADDRESS: 15 BUILDING AREA(if residential, new construction, remodel, or addition) 1200 _SF BUILDING TYPE: • .SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: GLYS. ELECTISI AL APIPLICAYION INFORMATION . . ....... . ... . ... CONTRACT PRICE OF WORK:$ oe NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES PrNO ASSOCIATED BUILDING PERMIT#(if applicable): 1 DESCRIPTION OF WORK': ,� �w �t�t`v�ILsC. �r TWt` Y,- ^ ,AAt-k-s- OWNER NAME- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY L T STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: i 11 7 CONTRACTOR ADDRESS: STREET /350 � _/ ,ry� 'Y STATE �✓ / ZIP CITYpJ� fJ 1, CONTRACTOR PHONE sr Z 6 p j CONTRACTOR EMAIL: a tJ3 tI �f, I Tr��- �/� '7 CONTRACTOR LIC,#(REQUIRED}: Mo CITY OF EVERETT BUSINESS LIC,#(REQUIRED):Or0N\3 8 PRIMARY CONTACT: ❑ OWNER *SONTRACTOR ❑OTHER(Please Specify) CON�TIACNTE: Zj N : ( CONTACT-PHONE: - -2 6I + S CONTACT EMAIL: AGREEMENT.•Thereby certify that 1 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 authorify to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That t 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 �OO,frD/ PERMIT# ze,& El Owner/Authori ed Agent Signature Date (Revised 10/1212015)