1830 HOLLOW DALE PL 2018-05-17 - Laserfiche WebLink

��C��I��L ��di Q� ��9�Q�� CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)A25-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits ��`�' �9�'� �f�II��LBh�fV�`�'9�� _ _ PROJECT ADDRESS: � �l�� I � �(z �� V('�` �-�+7� BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ��EC�i'R L.AP'6��,aCA�'IOId AR��OR�ii�7'90id CONTRACT PRICE OF WORK: $ � �� NUMBER OF DEVICES(if low voltage): F1RE ALARM? ❑YES ❑ NO ASSOCIATED BUfLDING PERMIT#(if applicable): DESCRIPTION OF WORK: � � C' ��S � ' _. CONTACT INFORMATION ` ' OWNER NAME: !�i 'ZC� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTRee-r CITY STATE ZIP OWNER PHONE: OWNER EMAIL: _ . _.. . . �-�Xx�t' D � ,. ... . . - CONTRACTOR NAME: 1�I��l � �C'-- ��c-� �— CONTRACTORADDRESS: srReer l yi y� �Z y > �� l= CI�IC 1 �lit � CI7Y �� /1 STATE V C ZIP _�-''..�.,-��.:.. CONTRACTOR PHONE: �( Z,S �• l � CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): W�1��I e�` �06 J �' CITY OF EVERETT BUSINESS LIC.#(REQUIRED):S�`S� . .. ..�.,:_... - .., ... .... ._.-,.._,:., _ .._........ _ _....,: . ..-.... ..,_._...,.. ,.. ....:.. ... ..:.:.: . ._.,....._ .:.. ._.:...,. ._ �.,. ...._.. ..,.. .,...-. : - - - PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) � ,�y CONTACT NAME: CONTACT PHONE: �2 j � / y� , y V C� / CONTACT EMAIL- . _ AGREEMEIVT. T h �eby certify thaf I have read and examined this application and know the same to be frue and correct. All provisions of/aws and ordinances governing this rype of work will be completed whether specified he�ein or not. The granting of a permif does nof presume to give authority to violate or cancel the provisions of any other state or local law regulating constructron or the peiformance of construction. That I am authorized by the owner of fhis property to perform the work for which application is made and 1 comply with the State Confracfors Law 98.27 RCW and 296.200 WAC. Cify of Everett Official Use Only FEE � I �� --- PERMIT# l �� i 7 � t�c�l -�a� OwnedAut ized Agent Signature Dafe (Revised 10/17J2015)