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_- - -- __-- -- ---� . <br /> �L�CTR�CAL PERMIT A�PLi�ATIt�IN <br /> CITY OF EVERETT PERfvlIT SERV(CES <br /> 3200 GE�AR STI�EET, �V`ERETT, Vt/A 9�201 <br /> (P)425-257-��10 j FAX 425-257-8857 ( (E)everetteps@everettwa.gov� wvwv.everettwa.gavlpermits <br /> P�tO�JE�T S�"#'E tN�O �TIeD <br /> �ROJ�cT��aaa���: � �� � � t , ` : �-v�r�� , ���.,C�� _ <br /> BUtLDiPIG AF2E,4(if resideniial,new canstruction,remodei,or addition) �,(��j SF <br /> BUILpIN�TYP�: �S�R-DETACHED ❑S�R-R`RACHER O DUPLIX L MULTI-FAMfLY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILOIRt�, � �_� � � � <br /> ��.���rr��cAt�aPPt���►TroN;���r��aM�°rror� , <br /> COR4T'RAC�"P�iC�oF Vlioi2mt: � 1 QO�, �� - 1�r„c �'Ja���e b he��-,2 C�w�^-��' <br /> hRlJ�BEft OF�EVECES if low vofta e : <br /> FIRE ALARM? ❑Y�S C !VU <br /> ASSOCII�I7ED BUIL�BNG PERMiY# if app{icable : <br /> DESCRIpT1��J�FlA��RK. �, �t�C�'rt ,� ��f'�l��.� � <br /> i <br /> � <br /> �e�t�rA��r tN���nn�°t°Ac�w I <br /> OWNER NAME: „ TENANT'P1AME(if Commercia{: <br /> OWlV�ft MAlLBFIC A[3ff7iZESS: STREET 1� j L_..� F'k`iJ� y v v�,} II <br /> �� �f Yk�,r v �lt STATE �,,�� zP � 2..`�1 � ', <br /> OWP6ER PHtZNE: 2,5 � 1'j - �� � OWNEtt EMAIL: ` �c�-�� (-�{ � e '��� , t'�'1 �li <br /> ca��Racra�z N,��: �`/ � <br /> ee�ras�c-roR aaooRess: S,�E� �� <br /> CITY STATE Z7P <br /> CONTRACTOd2 PM�NE: CONTRACTqR EiV1AIL: ' <br /> ��NTRACTQ�l.iC.#(REQUIREDJ: CI'FY OF�VERETT BUSIMESS LIC.#{REQUlsaED}: I <br /> PRI�,4RY CORITA�T: �OWNER 0 CONTRACTt}R €�t�THER{Please Specify) <br /> CtJN�'A�T N �: CC9NTACT PHt3NE: <br /> ��� ���,1 " � S?j i <br /> �-� CQNTACi'E�AAtL: l��Yl€' Ck, y , '�' <br /> AGREEMENT:1 hereby certify t f 1 have read and examrned ehis application and krrow the same to be true and corre�c. All provisians of taws and ordinances govemrng fhu type <br /> of work wit!be compfeted whethar specified her�in or noL Th8 granfing af a permit does not prssume to give authority to violate or Cancel the provrsions of any ather sfate or <br /> locallaw regulafing cflnstruction or the peerformance of consYruction. That!am authorizecf by the awner ot this property to peiform the work fior whrch applica7ion is rnade and 1 <br /> compfy with the Sfafe Cantractors Law 98.27 RCW and 298.200 IMAC. <br /> ����s� C�C�.�I -�,� `��r��►�� �� <br /> ��.� ���?�`� - 1�10 <br /> ��� City of Everett Official Use Only i <br /> ���\X, i <br /> % PERPvtIT# <br /> � f� � , -L. D � i� ���i '�,.,)� �� i <br /> OwnerlAuthorizsd Agen ignature Date (Revised 923i20J6) � <br />