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<br /> ` �� �_� � CITY��SF EVCR�TT PERMI�ERVICES
<br /> �--� 3200 CEDAR STRE�T, �V�R�TT, WA 98201
<br /> (P)�425-257-88�0 � FAX 42�-257-8857 ] (E) everetteps@everet�vva.gou� wt�vvv.everetfwa.gov/permits
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<br /> PROJEGTADDRESS: '2( � � 2G�c�t��t=�L��.- l�l.'i� Gt.�r'Sz�•r�r-
<br /> BllIL.D1NG AREA(if residen.iial, new construction, remodel, or addition) �r �' Sl=
<br /> BUILDING TYP�: ❑SFR-0ETACHFD �SFR-ATI'ACH�D D DUPLEX CI MULTI-FAMILY-#OF UNITS: L COMMERCl/aL
<br /> us�o�B�ut�nttv�: ''�-��s� �,� �0.�-h'1�c: ��S �f/C�
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<br /> �����'�����;�i�i�P�pc��'���� 8:������`�Q�1� � .
<br /> CONTRA,CT PRICE OF 1NORK:$ �C��
<br /> MUMBER OF DEVIC,�S (if low voltage}: 3
<br /> FIRE ALARM? ❑YES �LNO
<br /> A550CIA7ED BUILDING PLRMiT#(i�applicable):
<br /> DESGRIPTION O�WORK: ��w��- ��-�'"�; � �_•c,�-ti:-�-c���=T- I�i��-- C-� t�,�
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<br /> OWNER NAME: �. (� �'1.��.>'S�'��, TENANT NAME(If Commercfal):
<br /> OWNER MAILING ADDRESS: s�EEr �2 ��� `�a�''2�`'`�"°L' ��
<br /> CITY ��7K-i2��r` STATE l.n-�— Z1P
<br /> OINNER PHONE; OWNER EMAIL:
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<br /> CONTRAC70R NAME: ��_l�F.� S����� (L L_�u 7 JZ�� �
<br /> CONTRACTORAI]DRESS: sTREEr �� l�j � ! � c� L%� ZE; / �� � �� � ( S ��
<br /> cirv C� ��-c.;=t.rx:r� sra� L-�<4-- zip �`CS�� �C�,
<br /> CONTRACTOR PHONE: �-��, [�2Z� � � C�NTRACTCIR EMAIL: �i7-�/v�;v' �'— ���-5c
<br /> �' `�, �--lz 5 r t,£�i'�l��-l�'�7-'�c. (,e
<br /> C�NTRACTOFt LIC.#(REQUIRED): fs���L-�.SC �f Z�/ .S�j CITY OF EVERETT SllSfNESS L(C.#{REQUIRED)_a�I �L��
<br /> P331MARX COMTACT: L1 OWNER �-EflNTRACTOR ❑OTHL-R(Please Specify)
<br /> CONTACT AIAME: CONTACT PHOPIE; 2_E�Cc� �>�7� �`�T 5 �j
<br /> +J P��p�� CONTACT EMAIL:
<br /> AGREEMENT.�T hereby cerfiry fhat!have read and examined this app/icaiion and/tno�v the same to be true and correct, All provisions oflaws and ordinances goveming this
<br /> fype of work wi11 be completed whether specified herein or not The granfing of a permrt does nof presome fo give authorify to vio/ate or cancel the provisfons of any other state or
<br /> locallaw regulating const�uction or fhs performance of consfruction. T/�af!am aUthorizedby ihe owner of this property to perform fhe work forwhich application is made and l
<br /> cornply wifh the State Coniractors Law 1B.27RCW and 296.200 WAC.
<br /> -- �` "�. City of Evereft Official Use On/y
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<br /> ` _ CITY G�� t��`�:'�RET ' PERMIT#
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<br /> �--3�- �� -�� � �tC� �� -�55
<br /> Oi,vnei/Aufihorize Agent Signafw�e Dafe �RLVISBCI�O��Z�2O�J�
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