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� �f�l��`�G�OC��« � p���iv�ill�� Q�L���/����� <br /> ,- ,: , <br /> � r CITY OF EVERETT PERIVIIT SERVICES <br /> -:_ �`r�fir <br /> 320Q CEDAR STREET, EVERETT, WA 98201 <br /> (P)Q2�-257-889 0 � FAX 425-2�7-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits <br /> ,: _ - <br /> . <br /> __.._ <br /> ' ` PCi�Oo�l�C�`� �Q�'� �f�il�oOG'��I�u'��0�1 <br /> _ _ <br /> . . . . , _ <br /> . -. . _. _.. r � <br /> PROJECTADDRESS: �217� � J, � <br /> BUILDING AREA(if residential,new construction, remodel, or ddition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULII-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILpING: ���G '� ___� <br /> -- -�=-:-T--� — -- --_--_— <br /> •-, — — — <br /> ,. — — <br /> _ _ . <br /> GI�G�ll r d c�l��L�a"f3�?�O�L�li'DOhZ! Q1�!1G OO ff�V�LQ it'Q�G`� <br /> CONTRACT PR10E OF WORK: $ �p���� <br /> }�UMBER OF DEVICES (ifi low volt ge). <br /> F1RE ALARM? ❑YE5 O <br /> ASSOCIATED BUILDI�IG PERMtT#(if applicable): <br /> DESCF21PTl��I OF 1lVOR�: �C�O� �-��S C I� I�� . �"�'� ���E Z �12--�- ��`-�t�� <br /> ....., _ .. . . .:: - _ <br /> ,. . .._ . . _ <br /> - <br /> _ <br /> ��R��'W�� fl9�G�����'ff➢��. _ - . _ <br /> OWNER NAME:� �\C�,.)�1,�(� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDR SS: s�eEr ��U S 'r U� �'l. <br /> ���vi crrv � STA7E vP <br /> �WNER PHONE: Z�Y� ���� ����' OWNER EMAfL: <br /> _ . _.. . . ,. ... ,. _.-_.: .. ..., . _. . .. ... .. .. . . ...::. . ,. . _ . . . .. . . .. _ . __. . .. <br /> CONTRACTOR NAME: �C� � � �� c-��� C--- <br /> CONTRACTORADDRESS: srReEr (p C Q r 0`�'�1 G <br /> �� S�z z-- 3 <br /> � ��7y \R STATE � ZIP <br /> CONTRACTOR PHONE: �L� 2�i � S S �� COIVTRACTOR EMAIL: ' <br /> CON7'RACTOR LIC.#{REQUIRED): S't"��.� � �J �� CfTY OF EVERETT BUSItVESS LIC.#(REQUIRED): � � I� <br /> �.,_.:._,_ ._..._...,r_.� ,�.,... _._,:T-_ . .,::.,�. �.. .... _�m...... .... . :.._. . _,....,_. _..: _...:-,_ ,_:.,.-.: ..:.,.., _-: .:_... . _. ..w.._..�r..,. -_,. _ .�-:._ _.-.... __...., _�:_.... <br /> PRIIV(ARY COIVTACT; IA�OWNER ❑CONTRACTOR ❑OTHER(Please Specify) �.0� �l '�'l O�'I 1'�� � �-5 <br /> GONTACT NAME: CONTACT PHONE: Z�(� � � �{ 3� �'� <br /> f IJ�r 1��Jy,,� CONTACT EMAIL: <br /> v <br /> AGREEMEN :T hereby cerfify thaf!have read and examined this aqolication and lmow the same to be irue and correc% All provisions oflaws and ordinances goveming this <br /> type of work will be completed whether speci6ed herein or not The granfing of a permd does not presume to give authority to violate or cancel the provisions of any other stafe or <br /> local law regulating construction or the performance of construction. That l am authorized by ihe owner of this property to perform the work�or which applfcation is made and! <br /> comply with the State Contractors Law It3.7_7 RCW and 296200 WAC. <br /> ' City of Everett Official Use Only <br /> FEE ---- — <br /> �- s �— � <br /> PERMIT# <br /> ��� � 2��� � l�,-� � -- O< <-{ <br /> Owned horized Aye Signafure Date (Revised 10/12/2095) <br />