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— �. ��i����l�.�C�/��, p�I��i:���� �1�I��c��,`���P� <br />;' . �,. <br />.;�� � CITY OF EV�RCTT P�P,MIT S�RVIC�S <br />3200 GEDAR STR�ET, �V�R�TT, WA 98201 <br />(P) 4.25�257-8510 j�'AX 425-2�7-8F357 ](�) euerefieps@everetiwa.gov 1 uvvuw.evere�fwa.gou/permits <br />_ - - - . . . . - ,`��?1�.Cc��G�1� �� U'1� i���`�1���'�'B�I� � - <br />.... . ..: _ ., ..., <br />. <br />; _.- .... . ., <br />_... <br />. . . ... . <br />< <br />.:..:..:. _ _ <br />�::_:;.��.�..__;_ �.... _ .::.....:...: :..: .. :.: .--.; .::, : ...::- - :...:: „ ::,._ __= _ - -- - <br />_. ;.. _.:.:: :,:.:.... �.,,. , :.:.._... _ .:,. .. ,.:_-.. . ._..... .. ... ..� <br />PROJECT ADDRESS �l �j 5�,5 � �,I S �� <br />BUf�i37�1G AREA (if resideniial, new co struction, remodel, or addition) �� <br />BUILDIIVG TYPE: ❑ SFR-D�TACHED S1=R}�Z-fACHL17 LI L7UPL�Y. ❑ MULTI-FAMILY-#OF UNITS: L7 GOMMERCIAL <br />USE OF BUILDING: � -- — <br />. :,_...- .,.....,,,. _::..-�_. <br />-fn_._... _; .-:. . .. : . . - <br />, . - <br />,.:�•-.� .:-' ' <br />. . .,.:. :. ,.. <br />f _ - ' - ' <br />C01dTI�AC`i PRIC� C3F 1(l(ORK: $ ' <br />NUMBEI� �F p�V1C�S (if low voltag <br />FIR� ,�L/�R�ll? Q Y�S <br />ASSOGIA7'ED BUILDING P�RNIIT # <br />DESCRIPTION�OF WO�K: r� <br />D� <br />❑ NO <br />appficable <br />�(�;ra, <br />Qvut��t� w�nn�-::. ���•'r ' • • . ` L�D �'Jt� S • <br />OWN�R MAILING ADDRESS: srreEEr � j„�� <br />.. CITY L�_ C/ � v l� <br />PHflNE; <br />CONTRAC70R NAME: � Q rT"F' <br />CONTRACTORAbDRESS: s-r <br />��� <br />i ��� l� �•,�,i; <br />TENANi' NAME <br />% �� �� S �i <br />� . � <br />�OVITNER �tl+tAlL: <br />w�� -� � •�• - - - <br />� <br />� <br />STAIE <br />�� <br />STA"TE I-, �� ZP <br />CONTRAGTOR P}IOh1E. L Gt7�]TRACTOR EIVIAIL.: f' .� � s ' c h�-� . ✓' <br />�pjyT�p.C7'OR LIG. #(REQUIRE�}: (� I� � CITY OF EVERETT BUSINESS L G. #(REQUIRED); � <br />pR]MARY CONTAG7";�( CI �OWNER �`� CONTRACTOR LZ O�HER (Please Specify) <br />GUNTACT NAME: GONTACT PHOnIE: �/ � � ' ' J �� � <br />S�':a_ � g � � _,� 'i,� CDiVTACT E1Vf�11L.: <br />AGREENJENT.' T hereby cetiify fhat l have read and examined this application and know the same to 6e true and correet All provisions of laws and ordrnances goveming this <br />iypeofworkwi!/becomplefedv✓heiherspecifiedhereinornot. Thegrantingofapermitdoesno�preaumetogiveauihorityioviolateorcanceliheprovisionsofanyotherstaieor <br />loca/ faw regulating construcilon orthe performance of constrnction. That / am authorized by the nv✓ner oi this property io periorm the tnrork forwhich application fs made and l <br />complytvith the State Contractors Law 78.27RCiNand 296.200 WAC. <br />Ct ofEvereff Official Use Only <br />DwnerlAu <br />�' �� <br />, � <br />� �' . . <br />Agent Signa�ure <br />Date <br />�y <br />��� <br />��'1�,°: <br />PERMIT � <br />� I�������_— _ <br />(Revised 10/12/2095J <br />