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� <br />'� -- <br />v�� ` <br />���������� ����0� �������� <br />CITY OF EVERETT PERMIT ��VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8890 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />CONTACT INFORMATION <br />OWNER NAME: �j �,��— �--� � �� TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: sTREEr �U `� Yv�,�JC,.�.(�� �. <br />CITY C 'd�- STATE �/�- 7JP ' G� � L/ <br />OWNER PHONE: ��� C� • OWNER EMAIL: <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: srReer <br />CITY STATE ZIP <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: <br />CONTRACTOR L1C. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): <br />�. ,, .w ..:_ �__. . .. , . . . _.:..., .F ., .._. :. _ :....z- ,_ � _ ._ . _.,....,.. . ,_. , .... ,,.__. .._.. . _. . . . _.. ... . _ , . . ,. .,. ,._. ._�:� - ., ._... .� ._ ... --,.� � . . _..._..:. _.. .. ... .....: _ _ .._.. ._ _:_ _. . ._- . .. �..... <br />PRIMARY CONTACT: �OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: <br />CONTACT EMAIL: <br />AGREEMENT.� T hereby cerfify fhat I have read and examined this applicafion and know the same fo be true and correcf. A!I provisions of laws and ordinances goveming this <br />fype of wo�k 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 />/oca/ law regulating consfruction or the performance of construction_ That 1 am aufhorized by the owner of this property to perform the work for which application is made and l <br />comply with the State Contractors Law 98.27 RCW and 296.200 WAC. <br />�r <br />utfiorized <br />Date <br />City of Everett Official Use Only <br />FEE <br />,- % <br />��, :I � �� C'�. <br />� <br />PERMIT# <br />� I j ;�� J- `��;L� <br />(Revised 10/1?J2095) <br />