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-_ � ��:�c��r�o�a� p������a� ac�o� ��oo� <br /> �� � <br /> C1TY O� EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820� <br /> (P}425-257-8810 � FAX 425-257-8857 � (E) everetteps@everetiwa.gov� www.everettwa.gov/permits <br /> , . ,. - <br /> _ _ <. ,. ... ,.,, <br /> , fPl�B��l1GCc�1i' �051 C Oh�G��6'�h�/Q`�'�o0O�1 <br /> PROJECTADDRESS: Z OU / L�v�iG �e <br /> BUILD]NG AREA(if residential, new consfruction, remodel, or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: �� �u.�.. /a/f v'e S �t�c.� f <br /> _ . <br /> _ G���i`��d��L�6�Pdd���i'B�fi�9 QI�IIF�@�6r��u D�I�I ' _ , <br /> COfVTRACT PRICE OF UVORFC: $ 5 0� �= <br /> AlUIV1BER OF DEVICES (if low voltage);� <br /> F1RE AL,4RM? ❑YES "fl�1V0 <br /> ASSOCIATED BUILD1iVG PERMlT#(if applicable): <br /> DESCRIPTIOtl1 OFIA(OR�C: ✓'7��.-/ o � IZ'� V r ccc 7� �% ��� � c /�� i <br /> /� . / � <br /> T✓� /J G u ✓Y! d � 7�+� <br /> , _ <br /> , ..������� O���R�I�����_ .. <br /> OWNER NAME: TENAfVT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srrzEEr <br /> C�TY STATE Z1P <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR'NAME: � :� �c� E�c c ��i c <br /> CONTRACTORADDRESS: sTrteEr /J� SS `�� /`S���--��✓ �o� <br /> CIN �O Lf/ STATE �4 . ZIP � d 2 3 Z. <br /> CONTRACTOR PHONE: 3�� 7S7 /.�� o CONTRACTQR EMAIL: �✓��✓ , e�-�fv E, e.�i+. <br /> CONTRACTOR LIC.#(REQUIRED): o i.�Tei �y �� CITY OF EVERETT BUSWESS LIC.#(REQUIRED)OJ�3� U <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTA NAME: CONTACT PHONE: '%2j' rj'�/ �� 5 / <br /> •. / ��'� ��3/7 � CONTACT EMAIL: <br /> AGREEMENT.-T hereby certify that I have read and examined this applicatron and know the same fo be true and correct. All provisions of/aws and ordinances governing this <br /> fype of wo�k will be completed whether specifred herein or not The g�anting of a permif does nof presume fo give authority to violate or cance!the provisions of any other state or <br /> local law regulating const�uction or the performance of consfruction. Thaf I am authorized by fhe owner of tl�is property fo perform the work for which application is made and! <br /> comply with the Sfafe Contracfors Lav✓98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> � �� �S O <br /> PERMIT# <br /> �� � 1 � � �- � s � <br /> Owner/Aufhorized Agen4 Signature Date (Revised 90/72J2015) <br />