Laserfiche WebLink
s Ci c� � -- oo�-( <br /> ELECT���AL ��R�'-r �i��►��� �r� <br /> C(TY O� EVERETT PERMIT SI_fZViCES <br /> 320�CEDAR STREET, EVERETT',!NA�82Q9 <br /> (P)425-257-8810 � FAX 4�5-257-8$�7 � �E�everetteps�a everettwa.erov E .everettwa.govlpermits <br /> �Ro.���r�rr� �r��or��wa�c��N <br /> �RajEc�rsD�R�ss: `Z����I {`kc,i- b�l�•�. �.�re�z� f;.-> - �gZ�~1 <br /> SUILt?IHG AREAe(it residential,new construction,remodei,or additionjt"11G%u C:C"urS'�"W4tC��F <br /> BUILQING TYPE: SFR-OETACHED ❑SFR-ATTACHEd ❑ DUPLEX ❑MUL71-FAMILI!-#OF UNITS: ❑GOMMERCIAI <br /> USE 4?F Btll�[�ING: 't�`,t G�Pti"� SL.. <br /> �E.��"t`RiC 1. ��LIC TIQIW it��� J�°°A°I��rE <br /> CC7iVTRAC`(PRI�c�F WpRK:� d�G� <br /> PVl11NBER OF DEYICES if low voita e : <br /> �IRE ALAFihQ? RO <br /> A�S�CiAT�[�BU1LD1�9G PERMiT# if a icable : <br /> DESCRIP�IQN OF WORK: �, <br /> ��.0�e �� Y`�.i�.;t r� - �v 4 C2. "� 'Z�'� cr�'v�� <br /> `�:Y °` � <br /> ��OINTA�T 1NEQ�M TI <br /> OWNER NAME: �C�C%� -� �,Ar' TEN�NT NAME If Comrnerciai}: <br /> OYUNER MAiLiNG ADDRESS: sTUEEr 'Z,f � � <br /> CIiY '�' �.+ .SiRTE � � ZIP � �� <br /> �wNER�r�o��: °2� (� -- '2;2`7-- .. o�rN����aaL: .����.-t���%�.cc� � ��vic... . ��v� <br /> GQNTRACTOR NAME: C . —��' ��, <br /> CONTRACTOR ADDRESS: srrt�r ,� <br /> cirr t)�tL"t�'ti�,� �rn� ` ziP `�� � <br /> CON7RAC'TQR PHONE: ��".— j�—� C7 Ct�NTRACTOR EMAIL: 1 - ���.�•2 v"�l', Gt O! , C� <br /> GONTRACTOR LIG.#(REQUIRED): �1 � ` -� Fi(oS �'Vt N CITY OF EVERETT BUSIh1ESS LIC.#(REQUIRED: ����''� <br /> PRIMARY CQNTACT: p QWNER �GONTRACTOR Q 07HER(Piease Specify} <br /> C{7MTACT' A�IE: GONTAGT PHONI�: L - ")C9 <br /> �.�t`-� t E� : Gt?NTAGT EMAiL: �iC � �. �..��,�"Y"�C, <br /> AGREER4EtVT:t hereby certity fhaf!have read ar�d avaminad this applica�n and know the same to be Vue and corrr�t. ,4t1 provrsions of taws a rdinances goveming fhis rype <br /> of work wi17 be compteted whether specifred herein or not. The graming af e pe�mrt does not preswne to give au45onty to violate ar carr�e!the provisions at any other siafE or <br /> loca!taw r ulating c�onstructian tar fhe performance of xx�nstrucfion. Thaf(am autfiotrzed by the awner of ihis praperiy�to perferm h`�wark tor which apptication is mac�e and! <br /> , with t�s�Sfa rtetoFS t�T827RC,'V5�`Rrret�96,2�0_WRC- <br /> `��.._ <br /> ���r�';� ��� �tp,L� "��'�"��% `��, <br /> � � <br /> ���' ����:°�t.���-r !G�4KS�.��..o,Y,��,: � <br /> A_� � _�,• Crfy ol Everett()lficia!Use Cinty <br /> ,, �� ,_._.. <br /> _.__.. -- _...�......_..._—--._,__._._ __...__ ----� <br /> �, , J � PERMt�� �� � —�� <br /> ,_ � �o-�-t� E <br /> Ow tAuthsrrized Ageo�t Signature Date {Reviseti 923/2016) <br />