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LECTR1CCAL PERMIT --'1LIICCATlON <br /> "iCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425•-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettvva.gov 1 www.everettwa_gov/permits <br /> PROJECT ADDRESS: 7,5---.., J 4 r Mk i t.../ a. <br /> BUILDING AREA(if residential,new construction,remodel,or add ion) /q 9 q SF <br /> BUILDING TYPE: 0 SFR-DETACHED ISLSFRATTACHED El DUPLEX ❑MULTI-FAMILY-#OF UNITS: D COMMERCIAL <br /> USE OF BUILDING: <br /> — - - - - - - <br /> :•.._. ._ . • ..: � • <br /> -•.-:. �: ... .: .. ._ g.: ._ :: p-�:11�y �p pry pq+g �H .>....�_... ,:._ <br /> - • p ��ae..q��9 �a.pp p��1�-al]��tl�®IFI. Aa��YOiVIN�4'H;4�AC9''� _- , <br /> CONTRACT PRICE OF WORK: T }PO O Z o— • <br /> NUMBER OF DEVICES (if low voltage); - <br /> FIRE ALARM? 0 YES Itl NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: r--.-t_ Ale,c../ ni 6 h''' 'C-- <br /> ..:,...-1.-_,,:l.-:.COI+iTACT�.INFORMATION; -' .:: :- -: <br /> OWNER N k ' Al&, ,•h, j,iA/s."1,0 ,../d.,,,i TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> • CITY - STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: .. .. _ <br /> CONTRACTOR NAME: /A/C,e"�A 6 r i 2 i.,?(-4 J z/tie iii L - )"1 L i, <br /> CONTRACTOR ADDRES: srRexi 11 3,2 b c�9 c 7i 11 VE' ,,,vLL <br /> CnY /' t _ <br /> y /,vid-A. STATE 14-'44ZIP / .-.5 <br /> V <br /> CONTRACTOR PHONE: 41.,?,e 3 3 a '3 9 0 CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): A„/© n _r Ii L__L -0 CI Ly,h,P CITY OF EVERETT BUSINESS LIC.#(REQUIRED):v•,'a r o `' s <br /> PRIMARY CONTACT:m OWNER ❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: a„el g CONTACT PHONE: 4./#2,.r3)d 'j , 0 <br /> 1— rCONTACT EMAIL: <br /> AGREEMENT:T hereby certify that 1 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 or the performance of construction. That I am authorized by the owner of this property to perform the work for which appfcation is made and 1 <br /> comply with the State Contractors Law 18.27RCWand 296.200 WAC. <br /> City of Everett Official Use Only <br /> ' F1=- <br /> • <br /> 1 <br /> Z©. .aQ <br /> PERMIT# <br /> E (605 /q <br /> L � Date . (Revised 10112/2015) <br /> Ovvner/AutIiorized Agent Signatur <br />