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4'LIC p C� <br /> � A[I� PERMIT �"-.II LICATION <br /> CATION <br /> iiiir <br /> E- <br /> F . t 7--TCITY OF EVERETT FERMI 'VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov) www.everettwa.gov/permits <br /> PROJECT ADDRESS: 150 j -33 Z/Vb. .T VZ.KelL <br /> BUILDING AREA(if residential, new construction,remodel, or addition) SF PICOMMERCIAL <br /> BUILDING TYPE: El SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: <br /> USE OF BUILDING: O c i J <br /> 4,01 fdleAL APFWItAtiO14IIF09FOIIiGlt1Atiti <br /> CONTRACT PRICE OF WORK:$ 3 , `j O _ I <br /> NUMBER OF DEVICES (if low voltage): 0' <br /> FIRE ALARM? 0 YES ANO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): �/74 <br /> DESCRIPTION OF WORK: R p f / <br /> G' <br /> .. ...... :.. .:...... <br /> CONTACT INFORMQTION: <br /> QWNEI NAM a. , PI r r l�€ I= P Av2nth otD TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> u . . <br /> CONTRACTOR NAME: s... _8 I�1 rv6c..,��il�.�l c-.�... .., .. _.. .., ...._... .. .. . _ <br /> .....�.. ..,. _. _ ._....... ...__........ _-..�,._......,�....,.. <br /> CONTRACTOR ADDRESS: STREET // /n(.1Cal,Q- Ry/ <br /> CIN 'A'-1 STATE L ZIP l gC. G3 <br /> CONTRACTOR PHONE: L )-5�-737-3? CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): &Ir,•Le.PRIMARY CONTACT: �fL,I„ 114 ')O,4 CITY OF EVERETT BUSINESS LIC.*REQUIRED): 02 /R7 <br /> m D OWNER '<CONTRACTOR D OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: e--.)1 /?4 2e, <br /> _CONTACT EMAIL: <br /> . -_ _ _ / m 92-,c--73-7- 3 3 <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 orthe performance of construction. That!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 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> . <br /> FEE <br /> 14, <br /> , A ,2,_______ <br /> (41 1 <br /> __ <br /> _ , ________ <br /> / PERMIT* <br /> /Z /.. / V 2:// -(,:---- E (p() -- 065 <br /> Owner/Authorized Agent Signature Date (Revised 10112/2015) <br />