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4921 EVERGREEN WAY TROPICAL TAN 2018-05-16
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4921 EVERGREEN WAY TROPICAL TAN 2018-05-16
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Last modified
5/16/2018 11:24:57 AM
Creation date
5/16/2018 11:24:53 AM
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Address Document
Street Name
EVERGREEN WAY
Street Number
4921
Tenant Name
TROPICAL TAN
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_. __ _ - - __ _ _ I�����°�����_ �����`� ��i�����`�1��1-__ ____ ____- ----- ___.._ <br /> C1TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201- <br /> (P)425-257-8810 � FAX 425-257-8867 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits <br /> . . ,:..- . . ,. _.. . _,. ,� .. . <br /> ,.. , ..: <br /> - . <br /> ;. PROJEi�'i' SITE 91V�ORi1�;AT10M . <br /> PROJECT ADDRESS: ' � :�� —�/t�:: �(��%(> � ,c•L <br /> BUILDING AREA(if residenfial,new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING C('jy71��1'�,IC�� <br /> _ _ _. - - . -- <br /> ' ELECTRICAL APPL.ICATION INFARMATION <br /> CONTRACT PRICE OF WORK:$ �'�, <br /> NUMBER OF DEVICES(if low voltage :� I <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BU(LDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: I�1�Ti' ' I � L wCl , t I���- <br /> .., , . <br /> CONTACT INFORMATI�N. : _ <br /> OWNER NAME: TENANT NAME(IF Commercial): �" � �,� C�r <br /> OWNERMAILINGADDRESS: srriEEr <br /> CfiY STATE ZJP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ` �- �i� G � �f �l �-� <br /> CONTRACTOR ADDRESS: srReer I(C, � — :�j%)'i <br /> CIiY �I � 1 ��� � STATE V V 1-'1� ZIP �'' �) �� <br /> CONTRACTOR PHONE; ��-j.�j�j(�. �' ��� CONTRACTOR EMAIL: ��f� S�� /�S (i— )��� O t� 1 <br /> CONTRACTOR LIC.#(RE4UIRED): �j��T.S 1.5� C J CJ C�,�C� CITY OF EVERETT BUSINESS LIC.#(REQUIRED): �S t I�=� <br /> PRIMARY CONTACI': ❑OWNER CONTRACTOR ❑OTHER(P(ease Specify) <br /> CONTACT NAME: ��'��� CONTACT PHONE: J-���j �"�(=ti : �� �,� ' � <br /> • CONTACT EMAIL: (� .� i C i 7 ��' J�>SY� C(% ,� <br /> AGREEMENT.�Thereby certify that 1 have read and ezamined this applrca6on and know tfie same fo be true and correcf. A!1 provisions of/aws and ordinances governing fhis <br /> fype of work will be completed whether specified harein or not The granting of a permit does not presume fo give authority fo violate or cance/the provisions of any otherstate or <br /> local law regulaSng construction or the perfonnance of construction. That!am authorized by the owner of this property fo perform the work for which application rs made and 1 <br /> comply with the State Confracfors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett O�cial Use Oniy <br /> FEE <br /> . � � �°D' <br /> PERMIT# <br /> - �' � '�- 3 �- i� � 7 � �� 0�' b �� <br /> Own r AgentSignatu e Date (Revised 10/92/2095) <br />
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