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(;;;A:r- I-Y C LECTIRMAL PERMIT / -.LIlCATION <br /> r'Er CITY OF EVERETT PERMIT SERVICES <br /> --` - 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov i www.everettwa.gov/permits <br /> :.:- . :.:: 1PI•OJIEC T SITE:IMPAR A I .N ; ` : :1 '.. .::;.. : .` <br /> PROJECT ADDRESS: 674 g-- CQ4i)'C "F/ P <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF <br /> 'BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED 0 DUPLEX 1 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 0e71€65 <br /> -.. . :tile Raer-IL APPILgCA` >iON QNF®AATo®I-I <br /> CONTRACT PRICE OF WORK:$ /1^ / (O. C/ <br /> NUMBER OF DEVICES(if low voltage):. Yr <br /> FIRE ALARM? TES ID NO <br /> ASSOCIATED BUILDING PERMIT#(if pplicable):� �il�i '!�"cz�%�"�'L1 . <br /> DESCRIPTION OF WORK: 4 <br /> �� 7 --• /rid-WI,- 4 , / <br /> i <br /> 7 CONTACT INFORMATION <br /> OWNER NAME: MOO_ irc s ` ri /661NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReeT Il�� A/� 5t 2/ 24 6 <br /> 1, 31/ � tet` 6 <br /> CRY � ?%�!/1` STATE WA- ZIP g/��j`��y, <br /> OWNER PHONE: 138 e gd, clOWNER EMAIL:�'��'�r " _m(9/7,_ . . c51)/,`' �,— <br /> CONTRACTOR NAME: AV W(/Ve "r- <br /> CONTRACTOR ADDRESS: sTREEr Z0 i �� C � / <br /> CITY STATE O(,If ZIP rOt <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: if ,...e. ijiirej a - "e'G01-7--~ <br /> CONTRACTOR LIC.#(REQUIRED) 1jW) <br /> �1/ rC CITY OF EVERETT BUSINESS LIC. REQUIRED O <br /> .............�>�..,�>,�..�.,,.1.:.,,�.>�.,.,..-..�:..sv=v.-...xa..,:.�-,:,.:.�,..:._ —.�_..�..,.....,aM;,_ .. <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACNAME: g)ICONTACT PHONE: , 5'?6 , S-5-is <br /> CONTACT EMAiL: G ,C <br /> AGREEMENT.-T hereby certify that I have read and examined this application and know the same to be true anr3 correct. All provisions of laws and ordinances governing this <br /> type of work will be completed whether specified herein or not The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That i am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> # L\ 2 , 9 <br /> PERMIT# <br /> , 6 . 'ill live I ?- ' E Ilog 'DO?-- <br /> Owner•uthorized Agent ignature 1).a{( (Revised 10/12./2015) <br /> • I <br />