224 109TH ST SE 2019-01-30 - Laserfiche WebLink

EcaCAPERMIT aCas 004100. ,,,, :',L-V7,,,,,, CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 J FAX 425-257-8857 J (E) everetteps@everettwa.gov J vwvw.everettwa.gov/permits PROJECT ADDRESS: 2 2-i 1 or' o-r: 5 e, -ew. Yil - BUILDING AREA(if residential,new construction,remodel, or addition) SF ' BUILDING TYPE: 0 SFR-DETACHED El SFR ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: IEL GTI-:IC; IL, . PPL1 Ci1TFIt4 BNF*RI[lI 4,7110 :: CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES Cl NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: reiwitr-e ccvl,fac . e)Ct1 prn -li-- Ofrvvuiv it -HA isk ver . I 1 priiii-ed ray p aik i . *--MA, . J • _: . . ..• .. .-.:.. • CON`i`AG'f;lfNll`®RMATION ._. - "OWNER NAME: Vol(�,,! ryik„l AlogA TENANT NAME(If Commercial): OWNERMAILINGf ,'Z ADDRESS: STREET ,Z. i4 1 O 41Z ..fes ✓r IL` CITY STATE PU A- zip ei F20e OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET • CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: ' CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: El OWNER. ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT T hereby certify that l 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 I 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 il1G PERMIT# It , ro/9/7 E \-1D$'- I ❑ �� (Revised 10/12120 S +v+fle- r uthorized Agent Signature at 1 )