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EELEC 11 RICAL REKNIT " , lip ATION <br />N <br />CITY OF EVERETT PERMI RVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425•-257•-8810 [ FAX 425-257-8857 ] (E) everetteps@everettwa.gov j www.evereiiwa.gov1permifs <br />CCU <br />PROJECT ADDRESS: 3 0 L-> . Ce-_5 v �. ® � ' � / 3 7- <br />BUILDING AREA (if residential, new construction, remodel, or addition) SF <br />BUILDING TYPE: Cl SFR DETACHED 11 SFR-ATTACHED ll DUPLEX 1] MULTI -FAMILY -# OF UNITS: COMMERCIAL <br />USE OF RUILDING: Ayt ,%,+w, <br />+.•P:b4 <br />jj�1>>t1�+> 1T�11 v:�.�:.1:_> �., L._,.<_ ::t� t:.• «=t _ <br />`f S•. n1,F.1Et3:'e•r'•::k.�nT'u.9..-nA1_...__ <br />CONTRACT PRICE OF WORK- $ a S S.00 <br />NUMBER OF DEVICES (if low voltage)„ <br />FIRE ALARM? ❑ YES ANO <br />.ASSOCIATED BUILDING PERMIT # Cif applicable): <br />DESCRIPTION -OF WORK: W oy :a(> A [> V•.�� e S f' 4 �l w c� �s �-c�{� e <br />= ``-_- - - - - - - - - •'' �'• �COi+i`I':i�iCT jI�TD�jE�jY%ATipiej��` - ._- . - - •• - . - _ -- _ <br />6WNER NAMI i= p C t TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: <br />smFEr b <br />. <br />My <br />STATE zip <br />OWNER PHONE' <br />OWNER EMAIL: <br />CONTRACTOR NAME.. <br />O [ <br />Le_ <br />CONTRACTOR ADDRESS: <br />sTREE-r 513 <br />! 2 " 5A <br />CRY! <br />STATE ZIP <br />{ <br />✓ a' <br />CONTRACTOR PHONE: <br />& D 6 c' <br />CONTRACTOR EMAIL: ( <br />I+ <br />CONTRACTOR LIC. #(REQUIRED):_ <br />IA C, E � "Z <br />CITY OF EVERETT BUSINESS LIG. #(REQUIRED): <br />W ® Coo <br />PRIMARY CONTACT; CI OWNER <br />E,940NTRACTOR� <br />LI OTHER (Please Specify) <br />GONTAGT NAME: <br />d . _ , e ® t I A O _ _ <br />ONTACT PHONE: O L -7 Y 3 ^ S'p tS i <br />FGONTAGTEMAIL: <br />AGREEMENT' T bereby cei fythat 1 have read and examined this applicaflon and know the same to be true and correct All provisions of laws and ordinances governing this <br />type of work will be completed whetherspecified herein ornot The granting of a permit does not presume to give authority to violate or cancel fhe provisions of any other -state or <br />locallawregulatfng construction orthe performance of construction. That! am authorized bythe owner of this propeetyfo perform the workforwhich appTicaiion is made and 1 <br />comply with the State Contractors Law 18.27RCWand 296200 WAC. <br />Cit ofEvereit Official Use Only <br />Y <br />FEE <br />-013 <br />F <br />RIMIITn# �n <br />Agent SignaE Date <br />(Revised 1011212015) <br />