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��%� <br />I�► � y- <br />w � li � � 1� i a � <br />_ . _. . .► � , ,_�. . . <br />CITY �F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps�everettwa.gQv � www.everettw�.gav/permits <br />-- ...�-E���R��il�t.�;�1R?1.iC.1Y7`�li�l� 1��'�DItMI�tTtt�N <br />CONTRACT PRICE OF WO;AK: $ � <br />NUMBER OF DEVICES (i low voita e): <br />FIRE ALARM? ❑ YE �- -__.__-_-�iV��J�� � <br />ASSOCIA7ED BUILDING PERMIT #(if ap licable : �� ��. <br />DESCRIPTION OF W�RK: , x,, a ;��; , t�, ;� �, , �'�� ' �, � <br />' �rrii�i'�;�1 s�i��i��%i��.'�r��� .•,' <br />4WNER NAME: TENANT MAME {If Commerciai}: ���;, -:-� <br />OWNER MAILING ADDRESS; sTaeeT � �� �,?�r-� i � ( �rF_� �- "'� �" �'-?�;r� r <br />CITY �:��;1 t '.`y'��� STATE ,�,�,.„P,+,�.- Zlp-c <br />OWNER PWONE: = a"""�� �.f i w Y� �'�� Fi OWNER EMAIL: <br />CONTRACTOR NAME �? � �: ; � ��� . '"� ` � `�' � _ <br />, . <br />. � '._;i- ,� ... � . w� a�' - - <;€ <br />CpNiRACTOR ADDRESS: srREe1 �. <br />...::. _, <br />CITY STATE 21P <br />CONTRAGTOR PNONE: :� ' CONTRAC70 MAIL. ��.` �' � � <br />COMTRACTOR LIC. #(REQUIR D);�_ �� 17Y OF EVERETT BUSINESS LIC. #(REQuiRED): <br />, ,.� . .... , ,. _. .r, _ ...... _�,. <br />_._ ...�.. ....�.�.. �. _t _, ..., . ,_,.. _... ..�.._,. _.�. <br />PRtMARY CONTACT: � pW ER (�CONTRACTOR ❑ OTHER (Ple Specify} <br />GONTACT NAME: CON7ACT PHONE. '� -"` "- '� ° <br />� � �� CONTACT EINAII.: � � , � <br />� �-�, <br />AGREEMENT: 7' hereby csrtify that ! have read and examined fhis appiication and know the same to be true and conect. A�! provisrans of /aws and ordinances goveming Thrs <br />type ot work wiN be completed whether specrfied hereir� or not. The grantrng of a permit dces not presume to give authority to v;oiate or canCei the provisions of any other state or <br />local taw reguJat;ng construcfion or the pQrformance oi construction, That 1 am authorrred by the owner of this pmpeRy fo perfa�m the work for which applicafian rs made and 1 <br />comply with the State Confracfars Law 18.27 RCW and 296 200 WAC. <br />QwnerlAuthorized Agent SignatUre <br />�- /.3-�'G <br />Date <br />City af Everett Officra7 Use On/y <br />FEE <br />2�� . 25 <br />PERMIT # <br />E l l� �c( -- 0��1, <br />(Revised iD/i2/201.°iJ <br />