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���������� ��� �� �� �' �������� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)A�25-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits <br /> _, , _ , <br /> - PRAJECT SI�'E 91dFOI3iViA'7"!ON <br /> PRO.IECT ADDRESS: ,�� , � 1'`f���,y ),..�-- ��.,.�:;i�="= <br /> BUILDING AREA(if residential,new constructionj remode�or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED "C�"SFR ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> U5E OF BU►LDING: <br /> _ _ <br /> ELECTRICAIL APPLICa4`i'ION IWFORMATIOid <br /> CONTRACT PRICE OF WORK: $ -,,'r'�� _ <br /> NUMBER OF DEVICES (if low voltage): - <br /> FIRE ALARM? ❑YE5 `F�NGI <br /> ASSOCIATED BUlLD1NG PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �'�' '" J�� '�✓ ?-y- =-�<�{'���� �!_'�� I��=, �`- <br /> ' CONTACT INFORMATION : <br /> OWNER NAME: �J .{ t <br /> p,� " TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: s-rRee-r �'> ;'�; ��•�z-, �., .� �,<_,,���`� <br /> CffY —Gi������"�,�` STATE ZIP �),f-�C.' <br /> OWNER PHONE: OWNER EMAIL: <br /> ,_ . _.. . . ,.... _. . _ ,. .. . . - <br /> . . . .. . _ <br /> �, <br /> CONTRACTOR NAME: ;�'�, �, `�, ; <br /> CONTRACTORADDRESS: snzeer ' " '� `� �� �( ;� <br /> CIN .,�'.�, STATE � d�'-� ZIP ` '�.��: ��. <br /> CONTRACTOR PHONE: °/�x�`� -��,7'��� `��% �'-� CONTRACTOR EMAIL: <br /> CONTRACTOR LfC.#(REQUIRED):Nf�; �_,r ( f"'� '�'`' � � CITY O�'EVERETT BUSINESS LIC.#(REQUIRED): `!j��?�j (-- `� <br /> PRIMARY CONTACT: ❑OWNER ^ CONTRACTOR ❑OTHER(Please Specify) <br /> CONT/1,CT NAME: CONTACT PHONE: G,�`J�c� ;� <�1 � �f <-��� <br /> ✓=f, CONTACT EMAIL: <br /> AGREEMENT.'T hereby certify that/have read and examined this application and know the same fo be true and correct. All 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 /> loca//aw regulating construction or the perforrnance of construction. Thaf/am authorized by the owner of this property to perform fhe work for which application is made and/ <br /> comply wifh the State Contractors Law 98.27 RCW and 296.20o WAG. <br /> Cify of Evereit Official Use Only <br /> FEE <br /> "j �` , PERMIT# <br /> � 9 , ' _ , - � <br /> �� ,� ''���� �j l,1 � / �� <br /> Owner/ uth iz A��nt ignature m Date (Revised 10/i2/2095) <br />