2107 ROCKEFELLER AVE 2017-07-26 - Laserfiche WebLink

09/29/2016 THU 8: 48 FAX 425 252 1666 CM Heating 0003/004 E: .' 'CTRICAL PERMIT AN-LICATION CITY OF EVERETT PERMIT SERVICES OL 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) evarettepsgeve7ettwa.gov I www.everBttW8_g0v/perrnit3 7' J IpT.2.1T I PROJECT ADDRESS: 12 BUILDING AREA(If residantleii, new construction, remodel. or addition) 3F BUILDING TYPE; D SFR-DETACHED MSFR.ATTACHED ODUPLEX 0 MULTI-FAMILY-9 OF UNITS: 11 COMMERCIAL IUSE OF BUILDING: R, CONTRACT PRICE OF WORK: $ NUMBER OF DIWICES if low volts : FIRE ALARM? 11 YES ❑ NO ASSOCIATED BUILDING PERMIT# If appllcabla)_ DESCRIPTION OF W07:1_ 4, OWNER NAME TeANT NAME If Commercial): OWNER MAILING ADDRESS, STREET r Ok-r C rTly T-Ag STATE UR-1— z1P, OWNER PHONr:,. � L &?) (no?'q D(o F L _jOWNI!R EMAIL; CONTRACTOR NAME: CONTRACTOR ADDRFISS. STREFT CITY STATE zip CONTRACTOR PHONE;tL `,CONTRACTOR CONTRACTOR LIC,#(REQ UIRED): ,ITYOFEVE!RETTOUSINE!SSLIC.# PEQUIRIC)'j PRIMARY CONTACT: El OWNER ACONTRACTOR Q OTHER(Please Specify) CONTACT NAME: ICONTACT PHONE: ICONTACT EMAIL: AGREEMENT:Thereby vurtlfvthat h&va read end exAmined this app/lGation and know the 98MG to be true and correct- All'provisions of laws and ora ncGs governing lN4 typv of work will be completed whether specified herein or not, The granting of pernill does not presume to give authority to violate or cancel the prQv1slons cfany othsrstato or local law regulating construction or the performance of construction. That t arr)authorized by the owner of this property to perform the work for which application 15 made vnd I comply with the State Contractors Law 16.27 Rcw and 296,200 WAC. City of Everett Official Use only PEE PERMIT# tGC)9 - Z Owrilur,Aulhorlzed Agent Signatur* L)u(e (Revised 1011212015)