5610 BROADWAY 2018-04-19 - Laserfiche WebLink

��,��'�� '� ��.�� CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98209 (P}425-257-8810 ( FAX 425 257-8857 � (E)everefiteps@everettwa.gov] www.everettwa.gov/permits ,_. .. _. ,,.- . ,.,_ :. �_ : .: . PROJECT SITE INF013Mi4T10N' ._ _ . . _ . . .. . __ . _ -- PROJECT ADDRESS: � U BUILDING AREA(if residen6al,new construction,remodel,or addition SF ' BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL U5E OF BUILDWG: ,,. .,: _.. .._ _• -- --� - : ,-- ` ` ELECTRICAL APPLICA7'1ON INFORMATION CONTRACT PRICE OF WORK:$ 6„� � IVUMBER OF DEVICES(ifi low voltage):� FIRE ALARM? ❑YES ' NO ASSOClATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: '�p CC Gt '� � /� 'l�. 7� o o ✓`f' � . -� : ; .__ , . .. . . .. _ , ' = � : ,CONTACT INFORMATION _; OWNER NAME: �l,(.) TENANT NAME(If Commercial): OWNER MAILING ADDRE55: s�eer �j' C� D �� V CIIY �* O STATE ZIP � OWNER PHONE: OWNER EMAIL: .� . .. . . .. ,.. r _.�.. ,. ., .... . . , w . .. ... ..... . . . ........ CONTRACTOR NAME: s � � r � � CONTRACTOR ADDRESS: s�eer �+'�- � LtJ CIN �{' STA7E ZIP / �O� CONTRACTOR PHONE: �� —�J CONTRACTOR EMAIL: /'e I�G I'�t� e f✓1 C� CONTRACTOR L[C.#(REQUIRED):� V�-Q.S �.� � N� � CITY OF EVERE'fT BUSINESS LIC,#(REQUf D): PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: �'� � 9—q� � 3 � �`��'� �� CONTACT EMAIL: AGREEMENT.�T h reby certify that I have read and exa ined this applica�ion and know the same to be true and correct AH provisions oflaws and ordinances governing this type of work will be completed whether spec�ed 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 regulaSng construction or the performance of construcfion. That!am authorized by the owner of fhis properly to perform the work for which application is made and 1 comply with the State Contractors Law 98.27 RCW aad 295 200 WAC City of Everett O�cial Use Only FEE . '� �_ � PERMIT# � z��1�/ � E ��2 � l� Ow r/Auth zed Age ignature Date (Revised 90/12/2075)