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102_012c-2W-4. 61S L0GQJ
<br /> ELEC1 'ICAL PERMIT PPLUCATIION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P) 425-257-8810 J FAX 425-257-8857 (E) everetteps@everettwagov I www-everettwa.gov/perrnits
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<br /> PROJECT ADDRESS: 1,10 S a R• It. o d (.4 3'` r) L- 1
<br /> BUILDING AREA(If residential,new construction,remodel,or additi.n) SF
<br /> BUILDING TYPE: El SFR-DETACHED LI SFR-ATTACHED ❑DUPLEX El MULTIFAMILY-4OF UNITS: 14 COMMERCIAL
<br /> USE DF BUILDING: gOE' 'J 6, EV eErr
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<br /> CONTRACT PRICE OF WORK:$ j 1 / ZO
<br /> NUMBER OF DEVICES(if low voltage):•
<br /> FIRE ALARM? El YES NO
<br /> ASSOCIATED BUILDING PERMIT#(If applicable): Lek
<br /> - __
<br /> DESCRIPTION OF WORK: e1o�CQ t' L- k r) •1 �G k.;�.i I i�) IV "("4 sl .&v'(.
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<br /> ,.�•.r. -• - : - • � _:<c; ,COI�'�'ACT..•IAI�ORNIAT'10N:'.. ._ , '. •-, . ... _ •_,.
<br /> OWNER NAME: TENANT NAME(If Commercial): it..)G
<br /> OWNER MAILING ADDRESS: smear Po fox 3707 •
<br /> CITY .50+7 f_LGA STATE A- 41PelgJ21/ 2267
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: (WE—el/L. e,,OP5T,/,1e. r/a/0
<br /> CONTRACTOR ADDRESS: STREET PoiLox 4tQ / //��!�� /,
<br /> CITY'l 11/16•. IL- [ STATEV vp gg2,6 L
<br /> CONTRACTOR PHONE:4266-294 44 CONTRACTOR EMAIL: k/be-i . HMEre 'kit-wivri corn
<br /> CONTRACTOR LIC.#(REQUIRED): 60NLecc-7 O.' D l CITY OF EVERETT EiUSINESS LIC.#(REQUIRED):O'-tJ59
<br /> �., _ -. ...—....,... , .�,.«..y..•.�w ._.. . . .«� .. m.. r..
<br /> PRIMARY CONTACT: E OWNER ll CONTRACTOR El OTHER(Please Specify) •
<br /> CONTACT NAME:1) NiS CeD CONTACT EMAIL: DEN,) CONTACT PHONE: 2 "•[lJ-73 b' 5 tM, !� �1
<br /> • iJ 4 IS. �0 h IC�4/rl T. [1O1Y1
<br /> AGREEMENT'T hereby certify that I have read end examined this application and know the same to ba true and correct. All provisions of laws end 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 lawregulating construction or the performance of construction, That 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 18.27RCWand 296.200 WAG
<br /> City of Everett Official Use Only
<br /> FEE
<br /> 32.7 ? , 730
<br /> PERMIT#
<br /> AA/4 .J E 210 - 2( S
<br /> Owner/Aul orized Agen Signature Date (Revised 10/12/2015)
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