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:,' CCA <br /> _LECTRJICCAL PERMIT A-=-.'L TION <br /> CITY OF EVERETT PERMIT S 'VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps a©everettwa.gov I www.everettwa_gov/permits <br /> t�v <br /> -•I�:IfI�� -;:: :,..._,::=;'.1,,:,. .:,.,::',?':��a��.: <br /> C� <br /> -ANT . .. <br /> PROJECT ADDRESS: ,63 t l.�C.AC M1 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) t 7 S 6 SF <br /> BUILDING TYPE: 0 SFR-DETACHED FR-ATTACHED 0 DUPLEX 1:1 MULTI-FAMILY-#OF UNITS: 1:1 COMMERCIAL <br /> USE OF BUILDING: — ) 'N/V.�\e G:\f`k.)4/ C-e----2 . <br /> CONTRACT PRICE OF WORK:$ C l S 00 • Y i <br /> _ <br /> NUMBER OF DEVICES (if low voltage); <br /> FIRE ALARM? 0 YES NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 2 <br /> DESCRIPTION OF WORK: z•-7Q-.-N\Cer COOCZ_V ;"L_cli <br /> 1 <br /> ' COI+ITACt 1N011:[VI,AT[Ot+l -.-- ... . '_ -.-",'::::.-,•,-. <br /> . . __-_... _,.. <br /> C WNER NAME <=• LS?,-__ 6- ?A/. / TENANT NAME(if Commercial): <br /> £ <br /> OWNER MAILING ADDRESS: STREET t -- l -e kk& ✓+ <br /> CITY 'Aire..--t STATE (1 -, ZIP <br /> OWNER 92l :.7`7Yd __.. OWNER EMAIL: .. ..,�... : . <br /> CONTRACTOR NAME: . VljN\ l .11.-- j <br /> CONTRACTOR ADDRESS: STREET M VO X b `7 <br /> cnY Nf\ \ v\ STATEza ri 7 <br /> CONTRACTOR PHONE:`/2 � <br /> ) Z /-' � <br /> CONTRACTOR EMAIL: (..62:7))(..62:7) `__ <br /> CONTRACTOR LIC.#(REQUIRED):�G�I,k l e), `'\ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):CAL �t <br /> PRIMARY CONTACT: D OWNER &CONTRACTOR 0 OTHER(Please Specify) <br /> CONT NAME: CONTACT PHONE: Z )2/6 / F 0C1 <br /> ..� ('1 � .. .. CONTACT EMAIL: (A- <br /> AGREEMENT::T hereby certify tt?at I have -ad and examine• his application and know the same to be true and correct Al!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 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE — <br /> 4k-00 , -- <br /> PERMIT## <br /> - __.---.." —..o.' /(//15' <br /> c // / <br /> Owner/Auth.✓fid A.-. ignatu:y Date . (Revised 10112/2015) <br />