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Aug. 16, 2016— 3 : 35PM S-1-- Security IflC [���/ry In,1 �a t-il_ ' No 0728 P. 1 <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©everettwa.gov E www.everettwa.gov/permits <br /> hu K��.LM� "Y ?r•-•:::, <br /> P$1;09)i���'�5'f��'11 <br /> F�1'i��B�I4f1<:�,�� <br /> PROJECT ADDRESS. .. <23.,, ,,2. coli) Ave_ .0 <br /> BUILDING AREA(if residential, new construction remodel,'or addition) SF _ <br /> BUILDING TYPE:,Li SFR-DETACHED EI SFR-ATTACHED ❑ DUPLEX ID MULTI-FAMILY-#OF UNITS: _ COMMERCIAL <br /> USE OF 13UILDING: <br /> w to `. . F <br /> .,".•:,. <br /> CONTRACT PRICE OF WORK:$ I - <br /> NUMBER OF DEVICES (if low voitaye): 1/ - <br /> FIRE ALARM? D YES I' NO <br /> ASSOCIATED BUILDING PERIVIIT## if ap.11cable): <br /> DESCRIPTION OF WORK: a °' 0 °_ —:...[r .alk. • f. � <br /> -. We-4f- {1 . It A ail 0 cls diril LLy ''.. <br /> ';n . , 40N i4CTi 1N .O iOtiON'7 - <br /> NER NAME . TENANT NAME If Commercial): 1)0i1/40 1V ,LLAl;•, 0 !i ' ' <br /> OWNER MAILING ADDRESS: STREET - - <br /> CIN STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> . a_.... ._. -•�-T.. ... <br /> CONTRACTOR NAME: <` <br /> S©i���0 � �e.l,�l�i <br /> CONTRACTOR ADDRESS: sTR r a-1 1 ,;-Oirrikt St- <br /> CITY ,.V _ STATEE (,c A ZIP . 201 . <br /> CONTRACTOR PHONZ2SO 'II3055(� CONTRACTOR EMAIL: bR,�,1lerS", Soni .1-cOIzc`I C -. _�/_-__ <br /> CONTRACTOR LIC.#REQUIRED): 10'v I , 'l IS I CITY OF EVERETT HUSINESS LIC.#REQUI-• D): 13/V /1 <br /> — •...,__.--,_ -..�-- �- - __-_--_, .,-� <br /> PRJNMARY CONTACT: II OWNER i% CONTRACTOR ❑OTHER(Please Specify) <br /> CON T NAME: �J CONTACT PHONE: (4.2I5 - 7/ 'a5�3., <br /> (� <br /> - /I CONTACT EMAIL' �i'til(1 : -A on • A� • -- — <br /> AGREEMENT:T herebycertify that 1 have read end examined this application and know the same to be true and correct All provisions of l:ws 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 orhe performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and l <br /> comply with the State Contractors Law 13.27 ROW and 296-200 WAC. <br /> City of verstt Official Use Only <br /> FEE <br /> 15 -vo <br /> / PER tAi# <br /> V 1/4• Lai V11/2--/C--- . .1 •ii k6 E'016 It,,,oc( — s:A .2_1 <br /> owner/Authorized Agent -gnatura Date (Revised 10/12/2015) <br />