Laserfiche WebLink
ALL C T RIICAL PERNT <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 1 (E) everetteps@everettwa.gov J www.everettwa.gov/permits <br /> PROJECT ADDRESS: I.I. 3 N�( yN <br /> � 9-{ <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF ' 0 <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTi-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: • <br /> ..; :' <br /> .. .pLEpr°8p,t L4 AlpfPlqpi,,`I'll���9!9 �N)�®;^'�dATQ(])f� '. :..:.. : : �::: : s : .. <br /> CONTRACT PRiCE OF WORK:$ ( D-15-0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: (1..4,1,,y1 i141A, 09 Q / Gi�.ac•-.63 - SW� A1 <br /> o r'vst__Sc t ,. S �. p c.a�Ci✓i k i -c S +o <br /> -�o c tide l U <br /> .:CON "ACT >INIFOR.MATiON <br /> OWNER NAME: CLJj _ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: (.•pL((e' s3 " ' OWNER EMAIL: L 4- - �` V1� ` "c.-400-\ <br /> CONTRACTOR NAME: ,WV <br /> -n �1 <br /> CONTRACTOR ADDRESS: STREET �C•(J` J <br /> CRY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: . <br /> CONTRACTOR LIC.#(REQUIRED): CiTY OF EVERETT BUSINESS LiC.#(REQUIRED): <br /> PRIMARY CONTACT: El OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> 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 <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 I am authorized by the owner of this properly to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.206 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> E O — OS cC <br /> I LrL_ <br /> /bit( 1 (-7-- <br /> Owner/ fhor" ed gent Signature Date (Revised 10/12/2015) <br />