13110 19TH AVE SE 2017-09-25 - Laserfiche WebLink

LIelllwff omo i KlLoAL rtKIVII i AP#*A A i 1UN V!96ff CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits ROJECT'SITE INFORMATION PROJECT ADDRESS: 1_1k I 0 BUILDING AREA(if residential, new construction, remodel, or addition) Tyd SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUP_LE�X^ ❑ MULTI-FAMILY-#OF UNITS: OMMERCIAL USE or BUILDING: A� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ -0o l� NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES KNO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: ST/°t s_l \N P ©'Z L � j Y CONTACT INFORMATION OWNER NAME: VrG r TENANT NAME If Commerclal : JA L OWNER MAILING ADDRESS: STREET T Z 2 N CITY ^ STATE ZIP OWNER PHONE: _> — OWNER EMAIL: T A H(:)L-b I�J CONTRACTOR NAME: Le C 'SZ I C CONTRACTOR ADDRESS: STREET U CITY { STATE LA ZIP CONTRACTOR PHONE: Z S 3 —1�S�Z — CONTRACTOR EMAIL: &IJD FFLja-f CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 19 OTHER(Please Specify) AAZQITEC-_P;4& 7��l JCNTACT NAME: CONTACT PHONE: � (�...— �Z(� r- 4 �, L CONTACT EMAIL: N E' tk — AGREEMENT:Thereby certify that 1 have read and examined this application and know the same to be true and correct. Ail 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 I 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 ROW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# n,.,�. e. art>.ri e.,..M ci.,.,w... Hare /Roiiccii in/f7MAi�l