2117 43RD ST SE 2018-04-12 - Laserfiche WebLink

LLECTRIICAL PERM IIT AFPUUCATOON CITY OF EVERETT PERMIT SERVICES. 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everettwa.gov I vvww.everettwa.govlpermits :.:IPROJIEC'T S(TIE II)NIFO ..... ...... PROJECT ADDRESS: ail 1 `7 L` 3 or, ,c L J e BUILDING AREA(if residential,new c struction,remodel, or addition) SF BUILDING TYPE: ❑SFR-DETACHED SFR ATTACHED 0 DUPLEX CI MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING:• • - v) CONTRACT PRICE OF WORK: NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES ■ ASSOCIATED BUILDING PERMIT#(if applicabl ): DESCRIPTIO OF WORK: � (o G4 t c I C l C ' l T.� h" Old h e w ci v' 14) 5-tailed ..v0.,0 Code Coni liar 544, aJel a6e 5- due Ivo ae•y1 vof flue reef -fo -H4 ✓ver) /A 56 ,1path/ � � � GtYe2f �0 U � �a � / alt /- f, COid"Q`AC';I` )IIC:i�'®KHAT➢®N. • ; � .-.. : : ,:.� _ -.... OWNER NAME: /„,I Ai4 jiC�rO`l Zl� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 0 )1 / 4' Vd .<1` cn /e Y %V v O�` f lam/ qe-1 /STATE ZIP OWNER PHONE: K0 O /lO 6'Q (OWNER EMAIL // „ CONTRACTOR NAME: 41// JJ�j f��/fi/5 /e. 712-6/1 ✓UG CONTRACTOR ADDRESS: STREET poi; g4. - // y./ CITY Cj/e1//.G/e a s4 �� j / STATE ZIP CONTRACTOR PHONE:TO''(j/O-/'7� CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): /�/ �e ,�� P CITY OF EVERETT BUSINESS LIC.#(REQU-ED): '6-- (54.65 PRIMARY CONTACT: 0 OWNER •= CONTRACTOR 0 OTHER(Please Specify) CONTAC AM : CONTACT PHONE: (----;)(/'W e..-- 15 -k CONTACT EMAIL: AGREEMENT:T 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 FEE 411 PERMIT# Owner/Authorized Agent Signature Date (Revised 10/12/2015)