615 13TH ST 2017-09-25 - Laserfiche WebLink

IWLECTRICAL PERMIT VPUCAT�ON CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E) everefteps@everettwa.gov www.everettwa.gov1permits PROJECT ADDRESS: Z,3 0 BUILDING AREA(if residential, new construction,remodel, or addition) SF BUILDING BUIE LDING T E: [I SFR-DETACHED 11 SFR ATTACHED Cl DUPLEX El MULTI-FAMILY-#OF UNITS: CC — > OMMERCIAL OF BUILDING: ullsul N OAT10 N Ll FOR CONTRACT PRICE OF WORK:$ /"zq NUMBER OF DEVICES (if low voltage)". FIRE ALARM? 11 YES "4no ASSOCIATED BUILDING PERMIT#(if applicaple). DESCRIPTION OF WORK: AM T-1 ORMAT I -A IN tPONT C ------------- OWNE A-4VNAME(if Commercial): OWNER MAILING ADDRESS: STREET CITY STATE MP OWNER PHONE: OWNER EMAIL: CONTRACTOR,NAME: CONTRACTOR ADDRESS: s ErPE Z,"T3, CITY STATE Z P kr2— CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED)61065a u�o CITY OF EVERETT BUSINESS LIG. REQUIRED); PRIMARY CONTACT: El OWNER Pir3SONTRACTOR El OTHER(Please Specify) ICON CONTACT PHONE: 7 T �T NA CONTACT EMAIL: AGREEMENT.'Thereby certify that/have read and examined this application and know the same to be true and correct All provisions o#faws and ordinances governing this type of work will be completed whetherspecified herein ornot. The granting of a permit does notprasume to give authority to violate or cancel the provisions of any other slate of local law regulating construction orthe performance of construction. That I am authorized by the owner of this property to perform the work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT <0wn:ut�or1zedAfS3entSF ature (Revised 1011212015) erIA Date