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LILECTR CAL PERMIT A.1410LICATION. <br /> It►� a. CIN OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425.257-8810 J FAX 425-257-8857 J (E) everetteps@everettwa,gov C www.everettwa.govlpermits <br /> • <br /> PROJECT ADDRESS: 1 4z.,4%,11D — <br /> BUILDING AREA(if residentiai, new construction, 'remodel, or addition) SF <br /> BUILDING TYPE:ASFR-DETACHED 0 SFR-ATTACHED CI DUPLEX• 0 MULT1-FAMILY-#05 UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> . '' ,.: . .4001 R KAL APPLICATION INFOR MATIOPI .. . . <br /> CONTRACT PRICE OF WORK:$ 3 Zo," <br /> NUMBER OF IEVICEs of low voltage): . ^ <br /> FIRE ALARM? Q YES gpI( O <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> DESCRIPTION OF WORK: • t VSST +J-� �i��� _.�_ eLz. .S. <br /> • 414 s-•r • . . _ . • <br /> • <br /> • <br /> . ... . ... . . . <br /> • -'• • Ct7if�T�iCt 1.14.F0l��0l0Nr <br /> -OWNER NAME: . T NANT NAME If Commercial): --"'— <br /> OWNER MAILING ADDRESS: <br /> on? �V��� tt' STA-Fa 64 ZIP 8,1.4 <br /> OWNER PHONE: 2.,D4 "114:1 ( ?i- OWNER EMAIL: <br /> CONTRA TOR NAME: FPO <br /> CONTRACTOR ADDRESS: STREET ' 75t, /4:003 1 , f <br /> cry � C.� STATE L1OJ\ ZIP G <br /> P t�i1S`t'l <br /> CONTRACTOR PHONE: A-?-7-0C.-61.1g CONTRACTOR EMAIL: ren -F pabe�y , (1 RI=QU ✓t- <br /> CONTRACTOR LIC.#{REQI1iRED):"�p.pC�.e3jQ8 CITY O)=EVERETT BUSINESS LTC.#( IRED): b' <br /> PRIMARY CONTACT: 1 1 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE; crt,� �$ „ 5� L - <br /> CONTACTSMAIL.: <br /> ,f I i�Clllf� <br /> AGR&7MEN r•T hereby certify that 1 have read and examined this application and know the same to be true and correct. All provialons 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 few regulating construction orthe performance of construction. That 1 am authorized by the owner of this property to perform the work for which application Is made and 1 <br /> comply with the State contractors Lew 18.27 RCW end 286,200 WAC. <br /> City of Everett OIncial Use Only <br /> FEE <br /> q--"S <br /> PERMIT# <br /> r F .ft0S - \�? <br /> 0 orized ant Signature Bate (Revised 10/12/2015) <br />