2701 HOYT AVE 2017-06-13 - Laserfiche WebLink

CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I WWW.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑SFR ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ z- - NUMBER OF DEVICES(if low voltage):, FIRE ALARM? ❑YES ;iI1 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: CONTACT I1 . -* ATIION OWNER NAME:L 1- t 1 TENANT NAME(If Commercial): ( �( OWNER MAILING ADDRESS: STREET CITY (�`(/ J�t� STATE (,�� ZIP � OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET ��"��/� CITY tV (� 1� STATE W Loot L 2— CONTRACTOR CONTRACTOR PHONE: 2-4— 'i ZO �j�' CONTRACTOR EMAIL. ' r` __(e Q C c v+il CONTRACTOR LIC.#(REQUIRED6M'!f `1�E'e o L 9 '. CITY OF EVERETT BUSINESS LIC.#(REQUIRED): U �f PRIMARY CONTACT: ❑OWNER 21 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: __ --- 7sC) �J CONTACT EMAIL: AGREEMENT.Thereby cern 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 We of work will be completed whether specked herein or not. The granting of a permit does not presume to ghre authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 98.27 RCW and 296.200 WAC City of Everett Oficial Use Only FEE PERMITS# II 0D t Owner/Authorized Agent Signature Da (Revised 90/92/2095)