9931 19TH AVE SE 2019-06-11 - Laserfiche WebLink

,441 CITY OF EVERETT PERMIT SERV 3200 CEDAR STREET, EVERETT, WA 98201 ICES (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE MNF'OR AT1ON PROJECT ADDRESS: _l l 5/ / ' 4 'E - .✓--77- qp zo BUILDING AREA(if residential,new construction,remodel, or addition) SF • BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: /Ur i4N0_ ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 6,ZOo NUMBER OF DEVICES(if low voltage):, FIRE ALARM? 0 YES 610 ASSOCIATED BUILDING PERMIT#(if applicable): i1 DESCRIPTION OF WORK: r '�/ �/ O11i e-i"/iA6 .• (b) Gr 1127 /2-/2. 4'\)br 1A)i4Lfi e Xs-T- 70 9 ) //moi) G-O 477.0A CONTACT INFORMATION. . OWNER NAME: �-p iitie17! Coti- -- 1 pten22,VriENANT NAME(If Commercial): 4-r60 .f41Mrt. OWNER MAILING ADDRESS: STREET `/3/ i') 4 y1 j: /� crrY '�YZ� e STATE VOA ZIP y�,...0A OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: /??--- kf cc�.i_ X7 / - CONTRACTOR ADDRESS: STREET '.�QGJ /1. �7`� / 114(..,:,7" CITY c /., -ei< STATE ` ,�L ZIP 'g 'j CONTRACTOR PHONE:/-(Z-5-- - —467 7 CONTRACTOR EMAIL: 'In./In. ( /eri lif(cg—ireri`f/(',i(,'Ge9144 CONTRACTOR LIC.#(REQUIRED): .. Cy /�l PS t0 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 4� PRIMARY CONTACT: ❑OWNER . C NTRACTOR ❑OTHER(Please Specify) CONTACT NAME: _ CONTACT PHONE: 1 ---77 .- .92i1' "r l K \)4` 3o,1 CONTACT EMAIL: -7I-6',w).e/ec/Y/C `O ofr-f,ev,coo, 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 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 . Vq 2 / PERMIT# Cr & _ /114/A— v i• / 0 E k 02 -09 OwnerI uthorized Agent Signat e mate (Revised 10/12/2015)