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� ����G�.O c� � I� G�'�G3�v�0�' /� 'I�dC�Q���� <br /> CITY OF EVERETT PERMIT SERVICF_S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettvva.gou � www.everettwa.gov/permits <br /> _ _ _ <br /> �'���A��`� �B�'� �6����3�i61i/�a`�'0�1� <br /> PROJECT/aDDRESS: �jI�D l� ���"�f' C i SCrvi 3 <br /> SUILDINC AREA(ii residential, new construciion, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DGTACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTf-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDIIVG: <br /> , <br /> ���ca�'c�� ����a������ o����m��-'o� <br /> CONTRACT PRICE OF WORK: $ � �Ik �C� <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCR(PTION OF WORK: � -�,� � � � e t � [�t �vr �� � h�.I <br /> _- _ - - - ,_. . . - <br /> . . <br /> CONTACT I.NFORMATION <br /> _ _ _ . _. . <br /> OWNER NAME: of cJl�t�'�" - TENANT NAME(If Commercial)_ � <br /> OWNER MAILING ADD ESS: STREET <br /> ��7y STATE ZJP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME; ��Gpn Cor <br /> CONTRACTOR ADDRESS; sTREeT � a D 7 � S'� ,S l�J <br /> CI7Y ��L�'V� STATE � ZIP ��"O <br /> CONTRACTOR PHONE: — 7 - SG60 CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): GOD y06 $S CITY OF EVERETT BUSINESS LIC.#(REQuiREn): � �"I 'I <br /> PRIMARY CONTACT: �OWNER ❑ CONTRACTOR ❑OTHER(Pfease Specify) <br /> CONTACT NAME: CONTACT PHONE: ��S_ �S'� ' �q <br /> �unek� �I�����`S CONTACTEMAIL: e�iG�qrG�S �' G�Q�,�('{'l,>0.• ov <br /> AGREEMENT.�T hereby certify that I have read and examined this application and know the same to be true and correct, All provisions oflaws and ordinances goveming this <br /> type of work will be complefed v✓hetl�er specified herein ornot. The granting of a permif does not presume fo give authority to violate or cancel the provisrons of any other state or <br /> local!av✓regulating construction or the performance of construcfion. Thaf I am authorized by the owne�of this property to perform the work for m�hich application is made and! <br /> comply v✓irh the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> .1 , <br /> ,��J3.`) °JU� <br /> I <br /> PERMIT# <br /> � � '� �� " ��'��= <br /> �. ��'-� _ ��./�� \ — <br /> ., � <br /> Owner/Autiiorized Agent Signatin�e Date (Revised 10/17J2095) <br />, <br />