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1422 112TH ST SW SEATTLE VISION CHURCH 2019-08-20
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1422 112TH ST SW SEATTLE VISION CHURCH 2019-08-20
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Last modified
8/20/2019 12:01:34 PM
Creation date
8/20/2019 12:01:33 PM
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Address Document
Street Name
112TH ST SW
Street Number
1422
Tenant Name
SEATTLE VISION CHURCH
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,LECTRICAL PERS I1T llICA1] IION <br /> .r CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> PII30 `':��`fl l tdl IFI I�•�'� [, ,:. . <br /> PROJECT ADDRESS: I 4'.)-)— D-th St SW <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF <br /> BUILDING TYPE: D SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX Cl MULTI-FAMILY-#OF UNITS: l f COMMERCIAL <br /> USE OF BUILDING: _ h it h <br /> CONTRACT PRICE OF WORK:$ cv-0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? D YES V NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: <br /> (cC ru� C+hlree) e- ci 5-f-,wy <br /> w-:-h v evw U . <br /> ' ( hi-ee) i1 J '_l r-,or <br /> .. :. .406100'00.IF.000000.. ... <br /> OWNER NAME: <Se..e""If`i� V 9.i OP. ( )'\V(Yr i TENANT NAME <br /> (If Commercial): <br /> OWNER MAILING ADDRESS: STREET 11 -)_)p.- 11 -4k 9fr �7�vV t/�� <br /> CITY Cf7 `" STATE `��� ZIP / �$0 <br /> 1-/---, <br /> OWNER PHONE: OWNER EMAIL: b <br /> CONTRACTOR NAME:CONTRACTOR ADDRESS: STREET Q g i 64 *le_ <br /> qTy P STATE VLA ZIP irt <br /> CONTRACTOR PHONE*>) c' q _5— CONTRACTOR EMAIL: ' : -e I ec,*i c 44A 03 rtiecil <br /> CONTRACTOR LIC.#(REQUIRED): QAC 4($g'15 L— CITY OF EVERETT BUSINESS LIC.#(REQUIRED):O01 <br /> PRIMARY CONTACT: ❑OWNER I CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: C 1(\,0 CONTACT PHONE: C >c) <br /> CONTACT EMAIL: Tr;maelecti-zc_4-tA V 5r t\ Cov,t <br /> 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 <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 I 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 98.27 RCW and 295200 WAC <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> /adrak_ t EniD - och <br /> 90/92/2095 <br /> ner/Authorized Agent Signature Date (Revised ) <br />
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