3615 GEYER LN 2019-07-31 - Laserfiche WebLink

��C��'��,/��, f��G��B� �, � �I�B��'BCc��I CITY OF EVERETT PERMIT S .�ICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � uuww.everettwa.gov/permits , PR��'�' ��"�'� 0G�9�'OR�i�`�IOFd , PROJECTADDRESS: ��j J S �e �(7 e; "I' "I ZO SUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE; ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELEC7'RAC�#L AP�LICe41�'B�P9 eP�➢FORMA'T'ION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION O�WORK: ��(� Ci �L' �1 _ CONTACT INFORMATION - _ _ _ _ _ . OWNER NAME: �a ` � � �f TENANT NAME(If Commercial): OWNER MAILING ADDRE55: srREEr � � '� /l�� S�e � U � � S crrv fiuQ,�QX� srn� �✓7 ziP � g Z�� OWNER PHON • y ZS 23 � -(p(�ZZ OWNER EMAfL: CjV�7�a , I�I p �� , CONTRACTOR NAME: O�� CONTRACTOR ADDRESS: sTReeT CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REC2UIRED): _ .,.��_,,,v.. ._... . _ ,._.� ..,...._._ ....�.� �.,�,.� ._. . . _ , . __ . _�. . .. .� ._.v ....._ _ .....,.,.�.�. , . ,. . PRIMARY CONTACT: �Q OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: ��ri�e� ��'�P��C51� CONTACT PHONE: �ZS>3SGI-,�I U� �! ZS Z 3 -(A I J SV'(�'Ic3Y1c� �� (� cT1 CONTACT EMAIL: �VC�i�'Id� ,�1 ( 'Jt7 d � � AGREEMENT.�T hereby cerfify that 1 have read and examined this application and know the same fo be frue and correct. All provisions of laws and o inances goveming fhis type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authorify to violate or cancel the provisions of any other state or local law regulating construction oithe performance of consfruction. Thaf l am authorized by the owner of this property to peiform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Offcial Use Only FEE -� �� ?, � PERMIT# 9 '' �� 9 Z � i �� -�`?a Owner/Autfiorized Agent Sig ure Date (Revised 90/12/2015)