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�L:G���'13QCt��L pL��v�i�� /��'L�11 c� ���'l1C�l� <br /> - � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, VUA 98201 <br /> (P)425-257-88�0 � FAX 425-257-8857 � (E) everetteps@everettv✓a.gov� www.everettvva.govlpermits <br /> , . ,,- _ <br /> - _ <br /> -.; <br /> , <br /> _ - <br /> ` '- ' .; pGB��L C��T' ���'L �I�_[��Oy4 ii'�I.��i'QO.�I <br /> PROJECT ADDRESS: � (�'�,,-�,� ��- `71 -��i�,�- }- 7 , <br /> BUILDING AREA(if residential,new construction, remodel, or addiiion) SF <br /> BUILDING TYPE: �SFR-DETACHED ❑ SFR-ATTACI-IED ❑ DUPLEX CI MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OFBl11LDING: f�C.`,�►G'�il�)G,��1� r1'l� �__- — — -----_° <br /> _._: —:.. -. <br /> _ ,- <br /> L�I�G�1(G�➢�l��; L�PpaOC�1��OG� Dlr�'�L�Of(�1r�VL�1�0��!1 ' <br /> CONTRACT PRICE OF WORI�C:$ CjL,�;� <br /> iVUMBER OF DEVIC�S(ifi low voltage):� <br /> FIRE ALARM? ❑YES �J i�0 <br /> ASSOCIATED BUILD1t�G PERMIT#(if applicable): <br /> DESCRIPTlal�1 OF V1lOR�C: � �.� - � g<:�„l� I L`' �tc...i, • � <br /> - :: :. _..., : . <br /> : <br /> -` ��f�l`�'e��`� 9tal�ORi�IA"�'���7. - <br /> OWNER NAME: ' ;iv1�� �d TENANT NAME(If Commerciaf): <br /> OWNERMAILIPIGADDRESS: stReEr � M���` z� �ic1 � <br /> GiY �i�u� ,y'� STATE �� ZJP L��L�.' <br /> OWNER PHONE: �'Z.� �,f �� '�j OVl/NER EMAIL: <br /> CONTRACTOR NAM�: �+t�` ,�f eL�t i f, 'L <br /> C�NTRACTOR ADDRESS: srtzeEr �IG r� t�'� (� 5' `�U� �CS �'�'�° �L' <br /> CIN �(1�� �� STATE �V" � ZIP "l�� <br /> CONTRACTOR PHONE: C� Z v CONTRACTOR EMAfL:�'��'j "i�,.' }�j�r��'I�C�t�`t GcJ'_ � i,< • ��'.L <br /> CONTR.4CTOR L(C,#(REQUIRED): � �(�V��'L ^ � n CITY OF EVERET7 BUSINESS LIC.#(RE R D): <br /> PRIMARY COIVTAGT: ❑OWNER CONTRACTOR ❑OTHER(Please Speci�) / <br /> CONTACT NAME�•E�r � m� �� CONTACT PHONE: Z� t)' ��� <br /> . �.�, <br /> CONTACT EMAIL: ��� �- y �` '�.. ,,� � ( <br /> AGREEMENT.'T hereby certify that I have read and examined this application and know fhe same to be true and correct. AU provisions oflaws and ordinances goveming this <br /> iype of work will be completed v✓hether specifred herein or not. The granfin,q of a permit does not presume to give authority to violate or cancel the provisions of any other state ar <br /> Iocal law regulating construction or the performance of construction Thaf I am authorrzed by the owner of this properfy to perform fhe work for which application is made and l <br /> comply with the Sfate Contracfors Lavv 98.27 RCW and 2982oo WAC. <br /> Cify of C-verett Official Use Only <br /> FE� <br /> L� �— <br /> }'ERM1T# <br /> '" , �� C l �� 0� <br /> �� ' � L�t �� ! — <br /> oeY/Aufhorized Ayenf Signature Date (Revised 90/12/2015) <br /> � <br />