620 112TH ST SE SPACE 196 2019-08-16

��cr�i�� .nni�r ,�PP�tc,��iorv CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits £ PROJEGT SITE INFORMATION PROJECT ADDRESS: � �� BUILDING AREA(if residential,new construction, remodel,or addition) f�� SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ,. , ,. , _ __ � " ELECTRICAL APPLICATION INFORMATION ` CONTRACT PRICE OF WORK:$ � NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES �NO , ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: O�{ v (L�� , , . _ . . . GONTACT INFORMATION . ' OWNER NAME: P � TENANT NAME(If Commerciai): _. OWNER MAILING ADDRESS: srReer ' � -��$� l� crrv STATE '(/J� ziP OWNER PHONE: OWNER EMAIL: � a.� p CONTRACTOR NAME: fJ�t/I✓�—� '� CONTRACTOR ADDRESS: sTaeEr . CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIG#(REQUIRED): CITY OF EVERETT BUSWESS LIC,#(REQUIRED): PRIMARY CONTACT: �I OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: L.F ,, �� " � ��' �.�D�.,(�,"�, CONi'ACT EMAIL: ` " AGREEMENT.�T hereby certify that!have read and examined this application and know the same to be true a correct. Il provisions laws and ordinances goveming fhis 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 fhe provisions of any other stafe or 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 applicafion is made and I comply with the State Contracfors Law 18.27 RCW and 296.20o WAC. City of Everett Officia/Use Only FEE . ;,��j p� PERMIT# -�2 - �� E ��2" �� l Owner Authorized Agent Sign ure Date (Revised 90/92/2095J