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620 112TH ST SE SPACE 224 2019-08-16
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620 112TH ST SE SPACE 224 2019-08-16
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Last modified
8/16/2019 8:50:03 AM
Creation date
8/16/2019 8:50:03 AM
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Template:
Address Document
Street Name
112TH ST SE
Street Number
620
Unit
SPACE 224
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������o��� r�c����� ����������� <br /> CITY O�' EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P}425 257-88�Q ( FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everetfwa.gov/permits <br /> .; .: .. . .... . ..,_ _. ... .. ...:. . ..__ , . . - <br /> : .. . ,... . . .. <br /> . ... . _._. . . _. <br /> . <br /> . ;...... . <br /> , .- . ,�R��1��'�'����.0��'�R�d��'Q�6t�,:�:� �' ;• �..... . : . <br /> .: :. . .,. . ...._:. _. . . . . .. . ... . . . -:. .. . .:.. :. : ... .... .: .. _ ... .:_. _. .. . .. .. . . . , <br /> PROJECTADDRESS: �6 � 1 Z 2 � <br /> BUI�DING AREA(if residentiai,new construction,remodel, or addifion) � SF ' <br /> BUILDING TYPE: SFR-DETACHED ❑SFR ATfACHED ❑ DUPLEX ❑MULT(-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDfNG: ��s • <br /> ,_ <br /> .. . ... :.... .. . .. .: �... :.:.... ..>: .:....::.-...:�.-_::,...:.:.:.::.,...:•_.:.,_...;... _., ., .......,,.. .,;: ....: .:........_ . <br /> . ... :. .. . ,:---� - <br /> . <br /> •EI�.E�`i' . .. . - <br /> �ac������ec��e�� ������►�r�or�_':. :.__:�;-. .�.�... ... '. <br /> .. : .. . . ... . : . . . _ ..... . . .._. ..._. .. . . .. .. .. .. .. .. .. <br /> . . _ . ... ..-- - .... <br /> CONTRACT PRICE OF WORK:$ �d�"— ' <br /> PVUMBER OF DEVICES(ifi low voltage):• <br /> FIRE ALARtVI? ❑YES ❑IVO <br /> ASSOCIATED BUILDIRIG PER�lfIT#(if applicabJe): <br /> DESCRIPT(�N OF WORK: f�l-�� Go^"-�� 5 � �' �``''` <br /> � �-r �.� (� ��� 1 Cd��ec� _ <br /> . . _ . . --, .,-.. ... ,.-. ._ - .- <br /> . ... . . <br /> ..,::�.: _ . �..: . . T _. . . _.. . .. <br /> . .._ _... ._ . . . . . .. <br /> ` �' - �.. .:�... CONTACT�INFORMATIAN. :::: <br /> OWNER NAME: � � G �'e'" � �'�TE A�17' AME(If Commercial): <br /> OWNER MAILING ADDRESS: s-rReer ('l�l,J �Z �' Sr <br /> � C17Y � STqTE ZIP <br /> OWNER PHONE: L�� �� OWNER EMAIL: <br /> CONTRACTO:R NAME: � <br /> CONTRACTOR ADDRESS: srReEr � '� �j'� <br /> � CITY"O STATE ,�"� V IP <br /> CONTRACTDR PHONE: �D� �� "r-1� ONTRACTOR EMA[L: �'�p °' � ` ' C��\ <br /> CONT.RACTOR L[C.#(REQUIRED): CD�^P 1 �s ���L ��v C[TY OF EVERETT BUSIIVESS LIC.#(REQUPRED):65�3� <br /> PRIMARY CaNTACT; �CI OWNER � CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT E:� CON7ACT PHONE: '�QG L�Z-Z ^ <br /> < �i � I V °v a CON7ACT EMAIL: C,Q r�n. � Q ,1; � �`j✓{-- <br /> AGREEMENT.�T hereby certify thaf 1 have read and examined this application and know the same to be true and correct. Al1 provisions of/aws and ordinances governing this <br /> type of work will be completed whether specifi,ed herein or not. The granting of a permit does not presume to give authority fo violate or cancel the provisions of any other state or <br /> loca!law regulaSng consfruction or the performance of construction. Thaf l am authorized By the owner of this property to perform the work for which application is made and! <br /> comply with the State Contracfors Law 9&.27 RCW and 296.200 WAC. <br /> City of Everett Officia!Use Only <br /> FEE <br /> • `� D/ <br /> ��y <br /> � PERMIT# <br /> �'� r3 � � �� 1 l-� ��. 4 <br /> er/Aufhorized Agent Signatu Date (Revised 90/97J2015) <br />
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