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"�� � ��L����I1C�Q� pC���i��`� ��[��C�1� ��00� <br /> � <br /> \f ' CITY OF EVERETT PERMIT SERVICES <br /> �r r✓� <br /> 3200 CEDAR STREET, EVERETT, VUA 9820� <br /> (P)425-257-88'10 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everettwa.govlpermits <br /> ..: . .- :. ,.:. . , ... <br /> . . . _ <br /> - - - <br /> ,._.. <br /> - ' PI�O�7G��1' �Q`�C� �f�l���G�/�`t3fl�O�!': . <br /> PROJECTADDR ., _.- .. ., .. _.. .. ... ... . . :_ _.._. ,,._.. .. , _.._ : . _ _.. . <br /> _ <br /> ESS: � i l � `.7 /�-�/f� -i---lr�?`�.G"'�' !;� .G �<_�/ <br /> BUILDIIVG AREA(if residential,new construciion, remodel, or addition)_ SF � <br /> BUILDIMG TYPE: ❑SFR-DETACHED � SFR-ATTACHED ❑ DUPLEX L� MULI I-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> �� <br /> USE OF BUILDING: " 5 <br /> — --=�� -- - — =_- -- <br /> , . .. -: — - <br /> �b���c�Q�����r��o�a��o� pi�r�o�$���Qo� -� <br /> CO�ITRACT PFZICE OF WORK: $ -�yC�- • ` ` <br /> fVUMBER OF DEVICES (ifi low voltage):� � <br /> F1RE ALARiVi? ❑YES ❑f�0 <br /> ASSOCIATED BUILDIi�G PERMIT#(if applicable)_ <br /> DESCRiPTio�l OF ul/ORaL: a��-s%'�; L:� s �i�✓'1�1�'f�' r'N!C.G� .�� T S.'L<< � <br /> -: ._.. _., - <br /> _ ... :_ . . _ <br /> , _.��id`�',G��� fl➢�(G��113��"I�➢4�Q� - <br /> OWNER NAME: �:>l't .� ��`�`�j��'✓r S TENANT NAPVIE(If Commercial): <br /> �� � <br /> OWNER MAILING ADDRESS: srReEr `� � � F'�� '7 v� <br /> CiTY �✓(��,.C��� STATE G!/,-( ZIP �`��c:.-�( <br /> �WNER PHONE: ��'v� '- �1" S ' C.���G OWNER EMAIL: <br /> ._ . _.. . . .. :.. ,. _:_.. .. .... . . _. . -.. ,. .. . . . . ...... . ,. <br /> CONTRACTOR NAME: /L��•• C-, '— ��' r � <br /> r— S'� '..�> ` S'` SGv� <br /> C�NTRACTOR ADDRESS: sTReEr �l-/ ��7 / <br /> — ;i y�;.� G', <br /> CITY �Y%`G��UvlC' < STA7E . � � 7_IP <br /> CONTi�ACTOR PHONE: CONTRACTOR EMAIL: l.. C?f C' �,c" �' �',%'�� �S/= �� � <br /> CONTRACTOR L[C,#(REQUIRED): NJ6^(�j i' / 7� �' CITY OF EVERETT BUSINESS LIC.#(REQUIRED):��� �'�� <br /> PRIIVIARY CO]VTAC7: �7 OWNER ❑CONTRACTOR ❑OTHER(Please 5pecify) <br /> CONTACT NA1VlE: GONTACT PHOI�E: <br /> �. �i <br /> < �_G�;.. ; ��/�'�'Ujti� CONTACT EIVIAIL: <br /> AGREEMENT.'T hereny cedify that I have tead and examined tnis applicaiion and know the same io 6e frue and correct. AU provisions oflaws and ordinances goveming 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 provrsions of any other state or <br /> local law regulafing construction or the performance of consfruction. That I am authorized by fhe owner of this property to perform the v✓ork for which application is made and I <br /> comply with fhe Stafe Confractors Lav✓18.27 RCW and 296.200 WqC. <br /> Cify of Everett Official Use Only <br /> FEE <br /> � -��6� <br /> � �� � PERMIT# <br /> ✓ � �/' � i <br /> C-�'- <br /> � ��1�� i�� 9 �'� � ,►���`�� <br /> OwnedAufhorizedAgentSign� uy� Date (Revisedl0/12/2015) <br /> !� <br />