Laserfiche WebLink
"go-- ZLZLECT IC L PE MIT KATION <br /> Noiw - CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P) 425-257-8810 ( FAX 425-257-8857 j (E)everetteps@everettwa.gov j www.everettwa.gov/permits <br /> ' PROJECT SI'ZE:INFORMATIOAl _ , <br /> PROJECT ADDRESS: �� 1 Vii(/ r L t�19 71 ? <br /> BUILDING AREA if residential, w constructs remod or addition) `2/CZ SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: illi OMMERCIAL <br /> USE OF BUILDING: /04-cbude/P3V/— <br /> , <br /> ELECTRICAL APPLICATION INFORMATION - <br /> 2 ✓ <br /> CONTRACT PRICE OF WORK:$ ., 090 v • <br /> NUMBER OF DEVICES(if low voltage): I - s <br /> FIRE ALARM? ❑YES airs <br /> ASSOCIATED BUILDING PERMIT#(if applica le): i • / <br /> DESCRIPT <br /> CWOF WORK: ,V"—" f/vJG , - P94„ "1- • <br /> • <br /> .7— afte,e-//7g af-79,4- 1,-e / 721-6,Z0 - <br /> CONT/4,CT.,INFORiVIp IV <br /> T1O . - <br /> OWNER NAME: f 'j ,f)/44/4 64, yT NANT NAME(If Commercial): <br /> / <br /> OWNER MAILING ADDRESS: STREET p3/f ie ." tee/I'''. <br /> IrleirZeief CITY <br /> IV 701204 <br /> OWNER PHONE: OWNER,� EMAIL: /� <br /> CONTRACTOR NAME: 2! /L ..! .eCe' 'i'_ <br /> . , l�lir(..�' ,.p��. , .. ., w. .. ... ... <br /> CONTRACTOR ADDRESS: STREET 'O1 / �-, ,>v-� J?�d %( /J �/ <br /> r rly STATE `%4/7-- - ZIP ,;11 <br /> CONTRACTOR PHONE ;,iii ��j ���� CONTRACTOR EMAIL: EiL�'2% / C//c. ��//!jy-j¢fh7 <br /> CONTRACTOR LIC.#( QUIR 'i): CITY OF EVE T BUSINESS LIC.#(REQUIRED):l/p t!j-ibiaf; <br /> PRIMARY CONTACT: 'OWNER CONTRACTOR 0 OTHER(Please Spec' <br /> CON ACT NAME: :: :: <br /> NE: 3 �3 �P J rahIL: �/ " <br /> AGREEME :Thereby certify that I have read and examined this application and know the same to be true and correct All provisions of laws 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 violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That t am authorized by the owner of this properly to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 4 1. 02 ,5 <br /> PERMIT# - <br /> ,i 039e07--- E no -0(0(t).• /Authorized Agent Signature Date (Revised 10/12/2015) <br />