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<br /> �;,;::� C1TY OF EVERETT PCRMIT SERVICES
<br /> 3200 G�DAR STR�ET, LVF_R�TT, WA 9820�
<br /> (P) 42��2�7-8810 � FAX 425--2�7-8857 ] (E) everetteps@everettwa.go�j wvuw.everettwa.gov/permits
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<br /> PRD.IECT ADDRESS: Z��D 23�� sr ����w�- �2�r
<br /> BUILDIIVG AREA(if residen�ial, new consfrucfion,remodel, or addition) �Z�C' SF
<br /> BUILD[NGTYl'�: �SFR-D�T/aCHED �TTACNEI7 '�LEX �-Pf�.�"1�FAMILY-�OFUNITS: $�MMERCIAL
<br /> U5E OF BUILDIfVG: -�7fi��'!C QW11�t1 ,{/�lSreleK<< _
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<br /> coNTRAc`t�PRIc� OF WORK:� �
<br /> NUMBER��DEVICES (if low uoltage); �
<br /> �IRE ALARM? �#Y�S �
<br /> ASSOCIATED BUILDING PERIVII7#(if applicable):
<br /> DESGRIP?IONOF�11(O}�K: I�`�Tk�-L ��`� �'GT�(GkL SYS''�Nl
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<br /> Q3IVNER NAME;:� �.tT s� �'�'��� �� TENANT NAME(If Commercial}:
<br /> OWNER MAILING ADDRESS: srr�EEr 'C� 1 Z'Q tT W � 1 ��� ���
<br /> . ��y, ���W C3DD . STATE �� 7JP CJ�✓
<br /> OWNER PHONE: OWNER EMAiL: � �
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<br /> CONTRAC70f2 NAME: �YI ���d� �'''T �' -
<br /> CONTRP.CTOR ADDRESS: s�raEer S yYl{ A S �u1►'��[f
<br /> C�� STA"iE �P
<br /> CONTRACTOR PHONE: Z 5 �ZZ' �i� CONTRACTOR EMAIL: CQ Mi�t�Sa,rt� ,�1 Z��'���snah�,��sh��
<br /> Cp[�7'RqCTOR LIC,#(REQUIRED): ����T�� Q 2� C1TY OF EVEf2ETT BU5INESS LIC.#(RLQUIRED): Os0
<br /> PRIMARY CONTAC7'.N ❑ OWNER �'�L CONTRAGTOR �I O�N�R(Please 5pecify)
<br /> CONTACT 1VAME: GONTACT PHO�IE: C[�� ��— Zl7GG
<br /> �.�IS ����S a� CONTACT EIVIAIt.:
<br /> AGREENENT.'T he�eby certify that!have read and examined this application and know the same io be true and correct. All provisions of laws and ordinances goveming this
<br /> fype of worl<wil/be completed wheIherspecified herein ornot. The granting of a permit aoes notpresume to give aufhority to violate or cancel the provisions of any otherstate or
<br /> /ocal!aw regulatinq construction orthe performance of construction. 7hat I am authorrced by i/7e owner oi this properfy to peiiorm fhe u,rork forwhieh application is made and I
<br /> comply v✓ifh the State Contracfors Law 18.27 RCWand 296.200 WAC.
<br /> City of Evereft Official Use Only
<br /> FLE -
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<br /> PERMIT#1'
<br /> t� G _ �_ � �-� � , D��_----
<br /> . - — �� =tevised 90/12/2095
<br /> Owner/Aut[�orized Agenf Si iature Uate �1 �
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