Laserfiche WebLink
tLECTR CAL 1ERNI <br /> ✓ .— CITY OF EVERETT PERMIT SERVICES_ <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 j (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE IMO. <br /> PROJECT ADDRESS: Z CO( SYG EVEkE fi i� <br /> BUILDING AREA(if residential,new construction, remodel,or addition) NVA- ��DO SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> FUSE OF BUILDING:erI(-ta lx <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage):• <br /> FIRE ALARM? ❑YES iI NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): n <br /> DESCRIPTION OF WORK: ' V f&`- 1/I�f ) a 8 �1 I/ f t' k r0 1'1d7e rn ( ' <br /> Sd t' 5 4/ai f ran Cc n 0-6, ir1S�c 1,ep C%P I I art-4( C Cpl' (ft-) <br /> 1a��p,frn/q O�1_��'("S -+'o (FCI COMP(tA4'f 'a Frire'�(oo/`(,� �H-Ctog n Co,tinDc> rode <br /> 66 CI, <br /> ,:.. .C - TAC - <br /> OWNER NAME: f 4 V E 6l"rC- TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREEr ZC- yr G� <br /> City fie�Q 1 STATE W/s\ / ZIP 1 f 2©/ <br /> OWNER PHONE: LIZ 5 c q q cqq j OWNER EMAIL: �/Cl y��, / E1-I C��'j�Ili,c C2!"` <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET • <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> AGRFFMENT.•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 l 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 /> 1 <br /> PERM-1'# <br /> 7//: 2°7 F 11 <br /> • . Authorized Agent Signature Date (Revised 10/12/2015) <br />