4927 OCEAN AVE 2018-12-21 - Laserfiche WebLink

,11110P -LCT:BCA L PERMIT A L CATs iN CiTY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits . : OR®JE+ iP Nit 940 R>iikti n- PROJECT ADDRESS: a e Z , 4 t l-{ BUILDING AREA(if residential,new construction, remodel,or addition) 1 0.0 7 SF ' BUILDING TYPE: 0 SFR-DETACHED to SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: /V&& /10 111 Ci ELE6t$11:CA,1:;APPLICAT1®N WF®RM4010N CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES(if low voltage):. FIRE ALARM? 0 YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: llte c:e, 30X' 0 .9 /1 (tie tom/ 140 t, ON. . .:. T iNFORMATIAN- OWNER NAME: ,4eGC I c` 11✓)tt r p r ;,3 ti,3 . TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: /✓o r9 4c'r n, 2 l S j4 j`%G 1,1 c �.� ... . CONTRACTOR ADDRESS: STREET J/ 3.2 0 9 5.�� iij e /�/li CITY 4),/'/2,114tj h STATE ;/✓4 ZIP 9 fa DJ CONTRACTOR PHONE: L�o2.4".' I!" /3/47 CONTRACTOR EMAIL: ' CONTRACTOR LIC.#(REQUIRED): /!/B,2 Tf/L Y O c// /Y?J2 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): D3 2$0 V PRIMARY CONTACT: El OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: LA2.5"f 3J 2 '3 y d l' "„i► ' e/s,,kf5zj.c, CONTACT EMAIL: AGREEMENT:T hereby 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 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 local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 4'2:56 , -*? PERMIT# , _,"\.1 a t320 Owner/Authorized Agent Sig natur Date (Revised 10/12/2015)