|
� F: ,�, �����,-1fl�.I�C���.1�G���1�� �� �������aCG,� 1���i��
<br />,.,_f
<br />�
<br />�;�� C1TY OF EVCI�LTT PCRMIT 1:�.."'V1CCS
<br />�`'� 3200 GEDAR STR�ET, EV�R�TT, WA 98201
<br />(P) 42�-257-8510 J F/aX 425-2�7-8857 ](�) e�rerefteps@everef��va.gav ) www.evere�twa.gov/permits
<br />..,...,._.:==�:.:,.._..:, : - -,:--•..:;-:• .....::.:..:::,:.;. - - - - = - -- - -. �- - - -- - -
<br />_. . . ..._.. .
<br />_•._. ....�,_:� ..::.:.::.::..:>_:..;: _.,.,:::,�,..;..:.:�.�....:::-.:.:._:,..
<br />,,......,:::..�-:<.:::..°:°;::� ;:=:::.:�,....,_;.:.:.,..::=:-;,;:�:..;y:•:..::....,......_.
<br />:. .... ....... � ...,. :- � �k����l�V��t`9o0J�! .:
<br />. _ .. .. .. ,. . , -;'. . _ :.:. ` , tc���� �'T� - -
<br />:�_::;:��..�. .,..:. ��.:.:.: � ... _ — -- _ - _
<br />�1�� '�'.�8 :: .
<br />� -. . .. ,;. �: r-..:, : : . _ ... . ... . , ... .. . .
<br />.. .. ... .:..;.:,. � --._..
<br />,_ . . . .
<br />PROJ�GTADbRESS� �� O � l (�� ��'� �1-P�f-���`" �-w�e'6� �� �� �
<br />SUfLi71NG AREA (if residenTial, new consfruction, remadel, or addition) Z� ��
<br />BllILDING 7YPE:,�S1=R-D�TACHED Cl SFRATTACHED CI DUPLEY. ❑ MULTI-FAMILY-� OF llNITS: �I COMMERC(AI_
<br />USEOFSUILDIPIG: S IVLB���, -��j�„,�'1 � - _-
<br />:r;:-=: ' _ - .:�i
<br />� - - -
<br />CONTRAC'� PRICE OF WORK: $
<br />1VUMBE� C?� D�i/iCES (if low volfiage
<br />FIRE I-�I�.Rllli? ❑ Y�S
<br />ASSOCIATED BUILDING PERNt�7 # (i
<br />�ESGRIP710N OF WURK: Y�
<br />OWI�ER MAILING ADDRESS:
<br />�flWNER PHONE:
<br />CONTRAG7ORIVAME:
<br />CDNTRACTOR ADDRESS
<br />STREEr
<br />CI7Y
<br />S7REET
<br />TENANi" NAM� (If Commerc
<br />STAiE
<br />OWNER EMAit;
<br />�
<br />ZIP
<br />-- - ���V "� I ZIP � �
<br />�� � STATE
<br />CONTRACTOR PH01�iE: �l�s � �,Z � GONTRAGTOR �MAIL: )� G� l� 1 �i)� � �� l/
<br />Cp�1TRpCTOR LIC. #(RLQUIRED): �� b CITY OF EVEP�TT BL7_ NESS L[C. #(REQUIRED): i�
<br />pR1M,qRY COI�ITACT:rt L7 OWNER �❑ CONTRAGTOR ❑ ��NLR (Please Specify)
<br />GaNTACr NAM�: GONTACT PHO�IE:
<br />CDiVZ4CT ENtAIL.:
<br />AGREEMENT.' 7�hereby cerfifyfhat I have read and examined fhis applicaiion and know the same io be frve and correci. All provisions oflaws and ordinances goveming ihis
<br />fypeofworltwill6ecompleted�vheiherspecifiedhereinornot. �hegrantrngofapermitdoesrroipresumetogiveauihorifyfoviolateorcanceliheprovisionsofanyofherstateor
<br />locallawregula6nq construciion orthe per�ormance of construction. That! am authorized by fhe nv✓neroifhis properiyio perform fhe v,�ork forwhich applfcation is made and I
<br />complywith the State Contracfors!_aw 98,27RCWand 296200 WAC.
<br />City oi Evereif Of�cial Use On1y
<br />FLE �
<br />�� ✓
<br />--- - -- _ - - �
<br />PERMIT� �
<br />-� ; �1�. � c���-_���__—__
<br />Oi,vner/Ai�i:IiorizedAgen ynature Dat (Revised90/12/2095)
<br />
|