3510 SHORE AVE 2017-10-05 - Laserfiche WebLink

#tIOMICAL PERMIT JSPLICATION CITY OF EVERETT PERMIT Ave 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits Everett PROJECT SITE INFORMATION PROJECT ADDRESS: j / L) 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: ELEMIARRAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: NUMBER OF DEVICES (if low volta e . ` FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: h. L CONTACT INFORMATION OWNER NAME: d'4./V 6Z � v 1011 TENANT NAME If Commercial): OWNER MAILING ADDRESS: STREET CITY (/�r STATE ` ZIP /0�V OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CISCO Electric, Inc CONTRACTOR ADDRESS: STREET 22612 92nd Ave W ,,T, Edmonds STATE WA zip 98020 CONTRACTOR PHONE: 360-618-3038 CONTRACTOR EMAIL: maria @ClscoelectrIC.COm CONTRACTOR LIC.#(REQUIRED): CISCOEI914DE CITY OF EVERETT BUSINESS LIC.#(REQUIED):042432 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360-618-3038 Maria Nicodemus/Cisco CONTACT EMAIL:maria@CISCOelectrIC.Com AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws 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/am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# E � Owner/Authorized Agent Signature Date (Revised 923/2016)