Laserfiche WebLink
��������� ������ ��������� <br /> C1TY OF EVERETT i'ERM1T SERVICES <br /> 3200 CEDAR STREET, EVER�Tf', WA 98201 <br /> (P)A�25-257-8810 ( FAX 425-257-8857 � (E)everetteps@everetiwa.gov) wvw,r.everetfinra.gov/permits <br /> ..:. ..:..... . . - - - -- - - - <br /> . : PRAJECT:S17'E�IINF�IaM,AT1AN�:�:� � <br /> >.,__... .... ....:........:. ..- -: ,. ..: ..... .... . _....: ......:�,,___., :.. ......._, ..-.. .:.._.._.. ... . - - <br /> . ._�_ . ... .. . .. . . . .. �... . .. ........ �. <br /> PROJEGT ADDRESS: ,z � �Z'�-�� � � <br /> Bi1fLDING AREA{if residentiat,new construction,remodei,or addition) SF ' <br /> BUILDIN�TYPE: ❑SFR-DETACHED ❑SFR ATfACNED ❑DUPLEX C7 MUL7(-FAMILY-#OF UNtTS: us�COMMERCIAL <br /> U5E OF BIJILDING:��� � • <br /> .:. .,, .. .. ;.:-._.. - - - -- -- - - - <br /> � ELECTRICAL�APPLICATMON�INFt�R1VIAT10i�1 <br /> .. . <br /> , <br /> -. . ,. <br /> -.�...�:�.., . � ':�.. �..../.: ..: .. .� ...�.:..:..�.3.:.��•,���l.k..K:P>�...z,.�„ _{� <br /> CONTRACT PRICE OF WORK:$ • <br /> NUMBER OF DEVICES(ifi low voltage):� <br /> F1RE ALARM? ❑YES NU <br /> ASSOCIATED BUILAING PERMIT#(if appiicable): <br /> DESCR(PTION OF WORK: �,Q� � ,G. Un�-}'" <br /> �t� z,l <br /> :,, ..._. -_. : , _ . .. . _. . ... . _ . - <br /> .. :.� :. . . . <br /> ,. . ... �� � - - <br /> ;..::=;.: -- ��� . . � . .. �: �:.� .�C "E . <br /> �.0�1TACT..INFORi111AT10N: <br /> OiNNER NAME: 7ENANT NAME(if Commercia[}: <br /> OWNER MA[LING ADDRESS: srR�r <br /> CIIY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ��. ?�( �'py��- y, I r �.j,.�.. <br /> CONTRACTOR ADDRESS: sm�Er � ' � �r �L. <br /> Cffl' L�Gt�. S� STA7"E ZIP /�D <br /> CONTRAG70RPHONE: �Z��Zc�(�— CONTRACTOREMAIL: �I�t,S�e t rr+G; �Cdbi4 <br /> CONTRACTQR LIC,#(REQUIRED): �j U�'S�CS�32 CITY OF EVERETT BUSINESS l.iC.#(REQUPRED):Qj�oO� <br /> PRIMARY CONTACT:'��CI OWNER�VR�ONTRACTOR tl HCI OTHER(Piease Specifiy)� <br /> CONTACT NAME: GONTACT PHONE: ��%'1(oQ �?6� � <br /> CONTACT EMAIL: ' � ^ � � � <br /> AGREEMENT.•T hereby certify thaf I have read and examined this application and know the same to be true and correct A/I provisions of laws and ordinances goveming this <br /> type of work will be completed whether specified herein or not The granting of a permit does nof presume to gnre authorily to violafe or cancel the provisions of any other sfate or <br /> Iocallaw regulaSng consfruction or the performance of construcfion. That 1 am author"rred by the owner of this properly to perform the work for which application is made and l <br /> comply with fhe State Contractors Law 98.27RC1Nand 296200 WAC <br /> City ofEverett Official Use Only <br /> FEE <br /> � S �- -S O <br /> PERMIT# . <br /> ������ � ��a�-c - os <br /> Owner/A orizedAgentSignature Dafe (Revised 90/12/2075) <br />