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( f2,2,11W. <br /> CITY OF EVERETT 9 PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE II E, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE E:INFORMATION <br /> /PROJECT ADDRESS: I(e t E, -11-YY� • . S i <br /> !BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> C.--M4 <br /> USE OF BUILDING: R---6471--- —__.__ � <br /> J aL CCTi `'WAIL APPLICATION IC.�E�©Leff u IOL` <br /> CONTRACT PRICE OF WORK:$ _ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> ;DESCRIPTION OF WORK: ( , (1(J " <br /> i CONTACT INFORMATION - <br /> `^ -yam.... <br /> OWNER NAME: S1 .. r`� ►' Lfi`2A/ (`` �1(� ` ,,: f, <br /> I(_- ,IANT NAME(If Commercial): c N I7 <br /> !OWNER MAILING ADDRESS: sTREEr 6( t 6 1'). . 3-E-- <br /> --._ _.. Cm' P ..6 .40 _.... _._. _ _ . STATE ' I ZIPq<6.)_0 <br /> OWNER PHONE: c � r,,� <br /> OWNER EMAIL: �r i v �� *IW J 0 RS9) <br /> ,CONTRACTOR NAME: 71t-Lf 14 - -4.•,-• OyvvCi..--EL "-_ -6- A--2.1c., <br /> !CONTRACTOR ADDRESS: STREETT3 ( '51 A- -• S <br /> — ►Vlo 1 STATE ZIP <br /> 'CONTRACTOR PHONE: 331 7O fI _CONTRACTOR EMAIL: 16AMAINA QjAix-941-01'o, t <br /> CONTRACTOR LIC.#(REQUIRED): Al • -- P <br /> I�/�1(/�"IL/�-1�Q CITY OF EVERETT BUSINESS LIC.#(REQUIREDi�,��i'�' <br /> PRIMARY CONTACT: El OWNER .4CONTRACTOR 0 OTHER(Please Specify) : <br /> CONTACT NAME: CONTACT PHONE: t% <br /> gip- 3d1—.� 1/0 <br /> ,A ! "t, ' `i fQ__ CONTACT EMAIL:K C-l/iA,'V In4.(,orvt <br /> AGREEMENT:T hereby certify that f have read and examined this application and know the same to be true and 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!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 /> _____ <br /> City of Everett Official Use Only <br /> L± 2 <br /> E _. . . .._ - . <br /> , S__ <br /> PERMIT# <br /> (A)\J -- r:\A-)1\ -/i _0 <br />