4314 RIDGEMONT DR 2017-06-29 - Laserfiche WebLink

��'�� C��`� ��A`�a�� C1TY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8890 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits _ _ _ PROJECT Sli'� 9It�F�FtQViA`TIOIeI _ _ _ _. _`_: � _ _. _ PROJECT ADDRESS: �3 � � BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-AlTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: -��;, <� F't;,�y�'_ ELECTRICAL APPLICA7'ION INFORMATION CONTRACT PRICE OF WORK: $ � °'� ��'` - l �� NUMBER OF DEVICES (ifi low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: �� C' ��P C:� � �'v. 6 a : CONTACT INFORMATION _ ; ' '. OWNER NAME: —� � � h, ��a.r.r� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srrteEr +� i c� �i CITY ' ��-�Q � � . STATE ZIP� OWNER PHONE: � S —3 �j-- �� ( c� OWNER EMAIL: CONTRACTORNAME: S�� t�1 �� <� � CONTRACTOR ADDRESS: srReEr � (� ��{-� CIN • "i p -� STATE � ZIP `� CONTRACTOR PHONE: �-��"��5��' �3�� CONTRACTOR EMAIL: � (� .�,kS�� ry �'�!� C�{��(� �' , � CONTRACTOR LIC.#(REQUIRED): �r'�5��'r'� � �.— CITY OF EVERETT BUSINESS LIC.#(REQUIRED): � � �`l ....__,,,_._ ,. ,.._._.,.. _ ,_ _. _.. . ...._..., ... ...._ _.,...... ._.... _ .. .._ .._......._. .. .�.. . .... .... . ....._ .��___. . ......_.... ...r_. . . PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: i�,�r�.-' �' ' ^,.�C�� �, �..�)��j CONTACT EMAIL: AGREEMENT.T hereby certify that/have read and examined this application and know the same to be true and correct. All provisions of/aws 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 l comply with the Sfate Contractors Law 98.27 RCW and 296200 WAC. Cify of Everett Official Use Only FEE � �� � � ' P�RMIT �� -� � I ��-�� �� r, d �� N Owner/Authorized Agent Signature Date (Revised 10/92/2095)