5415 ROCKEFELLER AVE 2017-06-29 - Laserfiche WebLink

a�� a�' �� D�Q�fl�� CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98209 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits __ _ _ �. _. i PROJEC`T S17'E �tdF012h1�iA�'IOi� PROJECT ADDRESS: � � I 1C1� BUILDING AREA{if residential, new construction, remodel, or addition) �� b SF BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL '� USE OF BUILDING: ELECTRIC.AL. APPLICA°�'90N INFORMATION � CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUfLDING PERMIT#(if applicable): s( DESCRIPTION OF WORK: V � `,� " � CG�� 11 � IV 7 ` CONTACT INFORMATION ' OWNER NAME: �� Y v� �� ' �n TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srReer S � �UGK- : CIN ,� �/�jI - STATE �IJG� • ZIP OWNER PHONE: LY� �1 D-�U � OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: sTReEr CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CI7Y OF EVERETT BUSINESS LIC.#(REQUIRED): PRfMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: � CONTACT EMAIL: AGREEMENT.�T hereby certify that l 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 ivhefher specified herern or not. The granting of a permrt does not presume fo give authority to violate or cancel the provisions of any other sfate or local law regulating construction or the pertormance of consiruction. That l am aufhorized 6y tl�e owner of this property to perform fhe work for which application is made and I comply with the State Confracfors Law 98.27 RCW and 296200 WFlC. Cify of Everett Official Use Only FEE 6b � �bo � PERMIT# � �, c 3-�� , 7 � 1 ��"��,°I Owner/Aufhorized Agent Signature Uate (Revised 90/12/2015)