Laserfiche WebLink
���`��.a��l� G�'CG��ii�'� �I �8��`�fl o0�( <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32Q0 CEQAR STREET, EVERETT, WA 98209 <br /> (P)A�25-257-88�0 � �AX 425-257-8857 � (E) everetteps@everetiwa.gov� www.everettwa.gov/permits <br /> ,. ,. . ,. . _. . . - <br /> , -.___ _, ,. ,.. <br /> _ - ��o��c-� �i�=� a��oa��;��-'o� <br /> PROJECT ADDRESS: �� S l..'`� � = �� '��7 Wl i'�L i_._. �-:' � ' �j i '�� �l— <br /> BUILDING AREA{if residential,new construction,remodel, or addition) SF ' <br /> BUILDINGTYPE: ❑SFR-DETACHED ❑SFRATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: L'G{OMMERCIAL <br /> U5E OF Bl11LDING: ������ <br /> . . . <br /> _ <br /> --- <br /> ; ELECTRIC,A�.�►PPLICA�'IOiV 9M�'t3R1VIATIOid <br /> CONTRACT PRICE OF WORK:$ Z�;� <br /> NUMBER OF DEVICES(ifi low voltage): <br /> F1RE ALARM? ❑YES �d-fV0 <br /> AS50CIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: - 5"�T��� ,�� � " f? �: � �"7-L_� <br /> �� r� Z Li L C— C c i=;L-5 - <br /> __, • - – <br /> . .. , <br /> .._ , . .....�.– - <br /> , <br /> ; , CONTACT.INFORMATION :: - -- <br /> OWNER NAME: TENANT NAME(If Commerciai): �� �i,;2 i7 .� � N=� � <br /> OWNER MAILING ADDRESS: s-rRee-r ��'� ���-l_: l U��2 L�� v� � w �'-t -�,��: � 'Zs t= <br /> CRY -�1�(L� ,"( STATE (.� F-} ZIP ��� O �–�- <br /> OWNER PHONE: �f�S - � 3" Z Z Z OWNER EMAIL: <br /> CONTRACTOR NAME: p� r �_ � ��,J ,1 L c= v,'z.� <br /> CONTRACTOR ADDRESS: s-rr�eer �' ')� L 4=._ Y�,(;ti:,_� C�.f} _�- ( 2-- <br /> crrv �(�M,i�f�-%��5 srnre 4'�-"� va ���-j'c i2i� <br /> r 5,'� , <br /> CONTRACTOR PHONE: ZL' -,- �" ` � ��7! `� CONTRACTOR EMAIL: ,-��:�� � Yt r s � r� ., � r,:�l , ¢'i � ,-•,^ <br /> CONTRACTOR LlC.#(REQUIRED): ��j - S f=. ��L S�-�- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER F�'CZSNTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: � C ` . ��;� j � <br /> �C�E. � <br /> U� �-�,�,1.��- CONTACT EIVIAIL: <br /> A�REEMENT.'T here6y cer(ify that I have read and examined fhis application and know the same to be true and correct A/l provisions oflaws and ordinances governing this <br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to vio/ate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of constructron. That l am authorized 6y the owner of this properfy to perform fhe work for which application is made and l <br /> comply wifh ihe State Contractors Law 98.27 RCW and 296.200 WqC. <br /> City of Evereit Offfcial Use On/y <br /> FEE <br /> . � �J1� r . __— <br /> `� / ; <br /> L/ <br /> � PERMIT# <br /> / _�,�-�---_ � 1� �-�� ��� �- <br /> OwnedAufhorized AgentSignature Date (Revised 10/9?J2095) <br />