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06+'05I'2006 06: 11 25322821•56 GARNER ELECTR� PAGE 0?;'03
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<br /> '� ���,��„ CfTY OF CVEf��TT f'Ef�f1/fi� SCRVICES
<br /> 3200 C�DAR STFZ�CT, E\lERET`f', \NA 98201
<br /> (p) 425-257-8o^1C � F�X�1�25-257�8857 � (E) cuer�tte�s c�everEt�n�s.gou � v�Nvw.evere#t�n+�.gov/pen��EfiS
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<br /> PROJECT AI7pRE55: �,���— ��V-,
<br /> BUILCJIN�a AREA if resldential, new constructfon, remodel, or addition) SF
<br /> BUII_f�II�IG TYPE: I_I SFR-DETACHED 0 :��h-ATT/�C!-��I� ❑ DUPLEY. MULT(-FAMILY-�#�F UNI7S,_ ❑COMMEf�CIAI_
<br /> US�OF SUILDING: _. _
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<br /> C4P1XR2AC'� �R1C1�OIF WOIR�C: :� `"? . �✓�.1
<br /> NUMB�R OF DE!/�C�S lf Io�N voltac�o :
<br /> FIR���,41�R1�E? C�V�S (�:No
<br /> AS50CFtiAlf�lO �CDI��I�f� �°�Rlllll�# if applicable :
<br /> p1�SC�pP1�lON �F VVO�K:
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<br /> �OM�I"r'ACT 1,N�ORM.ATN�i�11
<br /> OWNER NAME: �' )'r� ��� 7�NANTi N/�M� ff Gorr�mel'Gi�1 :
<br /> OWN�R MAiLIN�Abb?�� �, � � ��•�� � �
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<br /> CITY � FT/�7K 1/� ZfP '*� �
<br /> OVIIN�R I�HON�: � � — � OWN�R�II�AI�: .
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<br /> CONTRF�CTOR NAME: ' (' "� �
<br /> CONT�AG70Fi�bi7R�SS; er��Er •��')r �� ' 'i,/ � ` �7 �� '+ �i
<br /> cilv a� F sTnT� - ziF �'� . ��;,
<br /> COI�STF2/aCT01�PI-lONE: ���' � :,�.-� GONTRAGTQR�11lIQ!l,.: �'� ' .V �], I� '=� C�,.Ci ��^��
<br /> CONTRACTOR LIC.#(RCQUIRF�) CITY O�E1JER�77�U5INESS L1C.�t(RGG�UIRED):�����a�,�`
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<br /> pRIIViARY CONT/1CF_ n OWNFI� I�CflNTRACTOR I��THFFZ(f lease SpeCl(y)
<br /> ��TACT NAME: CON'C�C`I'PHON�; ` � r'�'�, ` '
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<br /> �,���� �:,, � � C�NTACT EMAIL: �. a C�,� � r" ` a 1�'
<br /> AGREF_MENT:T hereby coNify that I have r3ad and exAminatl tl�(s appllcat/on�nc!Itnowlhe sarne fo he frue end correcf. A!1�rnvlF/nns n(/s�-vs snd ordlna�r,es gaverning thfs
<br /> type o(worlt wil!be completod wl)elher spocifrod he/�=fn or not. 7/1E r�rallfhlg of a permlt doeS r1c�t�resume tu gfVe aull1onTy 1n vlqlAte or cance!the provG�lons of anV other sfa(e or
<br /> iocel law reguiating construc(lon or fhe perlormdnr.e of consiruct/on, )'hA(I�m�ulhnrhed hy 1he owner of this ph)pGfYy to perform fhe worlr for ui111G/1 sR:p�icetion is madc and I
<br /> comp/y�v/th the St�(c Confr,sr.tors Law 1Q.z7 RCW anc9 2D6,7.00 Wi1C,
<br /> C!(y o�'Cvere�f Official Usc Only
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<br /> Owner/Aufliorizod Agcan4 S3gnat,rr �atc � (l�evfscd f0/1?/��15)
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