1816 112TH ST SE 2018-04-27 - Laserfiche WebLink

=�c-rRicAL P��n�i� ��ic�►�ioN CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-2�7-8857 � (E)everetteps@everettwa.gov� www.everettwa.gov/permits : _ , � ; . �.t ,.; `: ; ° : `; PROJECT SITE INFARMATION; PROJECT ADDRESS: I�J�i - ��a� �� _ . S�� ,U f} GI��C7 - BUILDING AREA(if residential,new construcfion,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: �'COMMERCIAL USE OF BUILDWG: � ST/�"Tf� ,. .. . .. _ . t .,: .,,, , . • �• _ � ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ �5D . � NUMBER OF DEVICES (if low voltage): (V�j ~ — � `J- ) 1 N FIRE ALARM? ❑YES ❑NO ��C'7"L7) L ASSOCIATEQ BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: S (/J T��! D 1 N S I N W 1 fLE � N f�� G� CONTACT INFORMA,TION OWNER NAME: � )L � � (,(�TENANT NAME(If Commercial): � 5 f� Q OVIINER MAILING ADDRESS: srneEr J g 1(p � I /�� ,rj S �� v r � STATE u�� Z�P `��dao OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: �NcS� N A �I !�f I/�(G- CONTRACTOR ADDRESS: s�eEr J'a1� �it.0�Z.r�E- ,�V � - CITY ��,�!�I 1 V STATE �JT ZIP /�J��J� CONTRACTOR PHONE: �o��— j�o�)D CONTRACTOR EMAIL: CT�"Ib Z3J�I /JS 1 �/ S 1 �J- CONTRACTOR LIC.#(REQUIRED): S J cSI(7 5 S S CITY OF EVERETT BUSINESS LIC.#(REQUIRED): OJ?' g�� PRIMARY CONTACT:�CI OWNER� �CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHQNE: r��Jc_ � _ a� D (��3�t Q �`(�b M S t�� CONTACT EMAIL: --r� (N ) � N, �j AGRE'EM�NT.•T hereby certify fhat 1 have read and examined fhis applicaiion and know the same fo 6e frue and correct. All provisions of laws and ordinances goveming this type of work will be completed whefher 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 1 am authorized by fhe owner of this property to�perform the work for which application is made and 1 comply with fhe State Confractors Law 18.27 RCIN and 296.200 WAC. � City of Everett Officia!Use Only FEE � �� PERMIT# � og -o3- �� E�,�� Owner/Authorized Agen Signature Date (Revised 90/92/2095)