2631 PANAVIEW BLVD 2017-06-28 - Laserfiche WebLink

�i�E�TRI�A� �ERl�/ll°� A��ICe�°�ION C1TY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: - �yG� BUILDING AREA(if residential, new construction, re del, or addition) SF BUILDING TYPE: ❑SFR-DETACHED FR-ATi�ACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 2� NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES �O ASSOCIATED BUILDING PERMIT#(if applicable): DES�TION OF WORK: .0 � �� p�L� . � CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTRee1 CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: � � L�� CONTRACTOR ADDRESS: sTReEr `GE:�GK � K/ �� CITY � STATE �� ZIP �g�� CONTRACTOR PHONE: �O�p— l�aZ� CONTRACTOR EMAIL: �� CONTRACTOR LIC.#(REQUIRED): ��C� G J(�L CITY OF EVERETT B SINESS LIC.#(REQUIRED): Qi��l� PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT N ME: CONTACT PHONE: � ` -�.�Zg � CONTACT EMAIL: � � AGREEMENT. T h reby certify that have read and examrned this application and know the same to be true and corre . Al/provisions of/aws and ordinances governing this type of�vork will be completed whet er specified herein or not The granting of a permit does not presume to give authority fo violate or cancel the provisions of any other state or local!aw regulating construction or the performance of construction. Thaf l am authorized by the owner of this property fo perform the work for which application rs made and I comply with the Sfate Contractors Law 18.27 RCW and 296.200 WAC. City of Evereft Official Use Only FEE � PERMIT# � � �� E �� Owner/Autlioriz Agent ' ature Date (Revised 10/12/2015)