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,��`�G���l�� ��G��Ii��l �� ��1,��'9��9 <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits <br /> ,.: ,. <br /> _. _.. <br /> ___ <br /> ,. . :. _,. <br /> ... <br /> , - : , 1P)RAJEC'�'SM`i'� IPI1FORi)/1�1,'�'I�RI <br /> . . _. . . _. . . _ <br /> _ _... ` . J _ <br /> PROJECT A�DRESS: � �- � � �/ <br /> BUILDING AREA(if residential,new constraction, remodel, or addition) SF � <br /> BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> U5E OF BUILDING: <br /> _. - -. _ - -- . ... . <br /> ELEC�"RIC,AL APP.LICA'�'101� IN�'C3RMATIOIN! <br /> . __ _.. �. _ <br /> _ -. .. _ _, .. _ _ . _ <br /> CONTRACT PRICE OF WORK: $ ���/l <br /> IVUMBER OF DEVICES(ifi low voltage): <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATED BUILDING PERMIT�#(if applicable): <br /> DESCRIPTIQN OF WORK: n � � �' LlC ��,�1 �� � �' C' <br /> � � i � <br /> "� �C� c' ' C; -' � ;� _ <br /> ,c , � �- /�' ' � ,/�L� �' . <br /> > : _ _ . ,. . , - <br /> . ._. . . _ <br /> _ <br /> ;.: <br /> - ,. ..CONTACT.INFORMATION :: - <br /> , __. ,.. . , : _ . _ , . .. - <br /> . . _ _. , . . ._.. . <br /> OWNER NAME: r� `% � ^ �^� TENANT NAME(If Commercial): <br /> OWNER MAIL(NG ADDRESS: s-rReEr <br /> CITY STATE ZIP <br /> OWNER PHONE: Z� p � � OWNER EMAIL: <br /> ... . _.. . . .. ,.. . _...., .. .... . , .. . . ... .. .. . . . . ....w,. ,. . . ,, . . ._ . . . .. . . .. _. . ... . ., . <br /> CONTRACTOR NAME: , (� \C.� <br /> CONTRACTOR ADDRESS: s-rReEr � J -^ ��- � <br /> � . / / J <br /> . U` .'t� CIiY � �� STATE ZIP ` <br /> CONTRACTOR PHONE: 2{� � �� CONTR,4CTOR EMAIL: � <br /> CONTRACTOR L(C.#(RE RED): f�{�1� � I � / � � (� .J �7 CITY OF EVERETT BUSINESS LIC,#(RERUIRED): <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please S ify) <br /> � <br /> CONTACT NAME: Jn J , GONTACT PNONE: � 7 � � � <br /> �,� � v � CONTACT EMAIL: <br /> AGREEMENT.-T hereby certify that l have read and examined this application and know the same to be true and correcf A/l provisions oflaws and ordinances governing this <br /> �ype of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority fo violate or cancel the provisions of any other state or <br /> local/ainr regulating construction or the peiformance of construction. That l am authorized 6y the owner of this properfy to perform the work for which application is made and l <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Officia!Use Only <br /> FEE <br /> � `..._.-- <br /> .� � ��c�3 -- ��� <br /> Owner/Aufhorized AgenYSignature Date (Revised 10/12/2095) <br />