Laserfiche WebLink
if LECTR.ICAL PERMIT ir PLICATION <br /> Niogil CITY OF EVERETT PERMIHIRVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 J (E) everetteps@everettwagov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 51\O RvC C$%iAs •' CV .'STT <br /> BUILDING AREA(if residential,new constructicremod ,or addition) SF 440.1 16F <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: 71t1 EV(1-dE$; n,p► ,, <br /> -. - CATION INFORMATION <br /> CONTRACT PRICE OF WO'K:$ C;9.-/5 O, <br /> , <br /> NUMBER OF DEVICES (if low ,• -. . eq-1 .-- <br /> FIRE ALARM? 0 YES 1NO <br /> ASSOCIATED BUILDING PERMIT It(if applicable): {.EOhjC <br /> DESCRIPTION OF WORK: ---rh,\04\-KIT INA f':PvIEN <br /> CONTACT-INFORMATION - <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE:.r :. (\,, P•`..,.., ,., . ..,.. ...W...... OWNER EMAIL: % w..— . _ ,. „.... .,, .. ., .—...,, ........_.,..> v_..,., ,.....,..,.,._., <br /> CONTRACTOR NAME: l-li-I Zy rpTfj'rw1t" ,{w.., �,,t< <br /> nP <br /> CONTRACTOR ADDRESS: STREET 3( e.t�..a.E.P... i VE. <br /> CITY EVegairi STATE GVA. ZIP leZd <br /> CONTRACTOR PHONE:3(00•C J e('T + CONTRACTOR EMAIL: , Ups& AOFFE L'J412ATT"C'N, t* <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER w 0 <br /> CONTRACTOR w C OTHER(Please Specify) (0PIF E .t.�. .� ..a.s. <br /> Gt11�12•IKTI,C?!•+( <br /> CONTACT NAME: CONTACT PHONE: 42.5" '14,_5,991 <br /> .C^ Rea MP+C -. CONTACT EMAIL: la.Ke,rGLGk--Cs ft%O}....(.40frI <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 property 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 g,--/,92. <br /> / PERMIT# <br /> FL if4fa' E �c�c� r on <br /> O, erl•iroriz:.Agent 'Ignature Date (Revised 10/12/2015) <br />