9801 19TH AVE SE 2019-06-11 - Laserfiche WebLink

,ECT ICAC PERMIT ,AP_ICA 1 N 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 www.everettwa.gov/permits PROJECT SITE INFORMATION. PROJECT ADDRESS: ?id I f� 11/ BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS:__ 1 COMMERCIAL USE OF BUILDING: CT CLS— • CTR CAL PPLICATION INFORMATION CONTRACT PRICE OF WOR ^ Se's'd` et..x NUMBER OF DEVICES(if to voltage): FIRE ALARM? 0 YES e ASSOCIATED BUILDING PERMIT#(if applicable): p DESCRIPTION OF WORK: ✓� dJ 8)(1 t L 13 i4t i fat tt AA,efL1 ti4 • (! , , CONTACT-INFORMATION. r { OWNER NAME: _!,, 'p TENANT NAME(if Commercial): ."rjt7 L 1J1� OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: AesOWNER EMAIL: CONTRACTOR NAME: INN5L,c f,>3 CONTRACTOR ADDRESS: STREET /J(D TV (t (i}'ytll.'� STATE f�f./�1 1 ZI' trr�it ctrr `� CONTRACTOR PHONE:t'f if 6,0431---8g3 CONTRACTOR EMAIL: Wfd& INN41iiQ 6—£' r'r -C CONTRACTOR LiC.#(REQUIRED): _jU/tJ1:�1.jat'S I A � CITY OF EVERETT BUSINESS LIC.# 'EQUiRED):O5 PRIMARY CONTACT: 0 OWNER t QONTRACTOR 0 OTHER(Please Specify) ~y CONTACT NAME; CONTACT PHONE: 'y2S_ Sal —��0-3 �� H66 CONTACT EMAIL: 1 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 7l 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 regul.ing construction or the performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and I comply with the .tate Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE (0*) PERMIT# _« _� Elms -O* Owner/Authorized'• t Signature Date (Revised 10/12/2015)