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_.L CCTR]CAL PERMIT n PUi CCATION bk CiTY OF EVERETT PERMIT SERVICES mo 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425•-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 wuvw.everettwa.gov/permits 'r:..n1:_.'..•.:'. ::' ..:L.Win:.,-...,- PROJECT ADDRESS: . G t;et,s,i /��u^G iAve- L--verreTr' BUILDING AREA(if residential, new construction,remodel, or addition) 51 a SF BUILDING TYPE: 0 SFR-DETACHED )I SFR ATTACHED 0 DUPLEX 0 MULTi-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: • CONTRACT PRICE OF WORK:0512 5 c7e-, • NUMBER OF DEVICES (if low voltage); • FIRE ALARM? 0 YES N NO ASSOCIATED BUILDING PERMIT#(if applicable): LL 11 L �/ n /n� / DESCRIPTION OF WORK: AAA- 1 Gi('Gu;+ 48 -111e. vnr.u/ et.�tl4i or. , Appr-tx //) of J(e. ev Cay. l to I1 I IAA's* 44 & s Lo Jct . • ... . 1:'„..!,::: ;". : CONT:A;CT�I.NFORNiAT101V` :� .:_: i: _ _ . . _ . . OWNER NAME;: I eS• )(kue 177O1 e, S 6_ TENANT NAME(if Commercial): OWNER MAILING ADDRESS: J STREEt 14 - C rV tkS"'11(,� ykri e-r L1114 O , Oxy ern' V�/r7 G�e ) STATE WA ZIP /CZ6V OWNER PHONE l O(O)1 Q5`41 Z OWNER EMAiL: ,`/._.. _ .w._ _ .._._,.._._ .. ,, ...-•...-- _.•. CONTRACTOR NAME: fro Am El e-c�A r i c_ 2 if e. / - CONTRACTOR ADDRESS: STREET �Z]O / O Z S-[. S� '�/ c/� CITY NIA-b(lf )�I STATE "� �1 ZIP 90JV6Z CONTRACTOR PHONE: 253' S 3 --�f 5 3 7 CONTRACTOR EMAiL: it-on y raid Z�.G e 14 /oJ qm t�,/ - e 0 YLs CONTRACTOR LIC.#(REQUIRED): 0£L-.QD O 12/r C.- CITY OF EVERETT BUSINESS LIC.#((REQUIRED): PRIMARY CONTACT: ❑ OWNER IX CONTRACTOR El OTHER(Please Specify) CONTACT NAME: 1-61(1 LA 'J6 �e�- p CONTACT PHONE: 25 3 r S3 - iI S 3Y ,✓ CONTACT EMAIL: • C{olt_G� e 0 - 4 )) • , AGREEMENT:T hereby certify that I have read and examined this application and know the same to b • and correct. All provisions.'laws and ordinances governing this type of work will be completed whether specified herein ornot. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this properly to perform the work for which application is made and i comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE * MO, CP PERMIT# 0- S - /7 /6 E (005- \a2) _ Owner/Authorized Agent Sig re Date (Revised 10/12/2015)