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���������� ������ ���������� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR�ET, EVERETT, WA 98201 <br /> (P)425-257-88'10 ( FAX 425 257-8857 � (�)everetteps@everetiwa.gov� www.everetfinra.govlpermits <br /> , . .. .., . . . . ,.. ...... . . . _ <br /> ,.., ....,.:..a«., _ . . <br /> _ . <br /> .... <br /> ' �. •. � • -._>:. . : . .����E�`P�I9°� dN���6�i�`�'8�6�9'.: _.�.:';.- :': _ <br /> ..... . . ... .. ..:. . . . ... . . . <br /> PROJECT ADDRESS: � ` � E d''J`�� � �. <br /> BUILDINC AREA(if residential,new construcfion,remodel,ar addition) SF ' <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX pMULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: ��� - <br /> _, ..:..:. ... ..:..:.....:: ..:�.;:_......._.:.._.::.--..,..�......,.,.:.: :_..::..,�.......:..-�'OItlVldal � N . : . - <br /> . : . - . _ <br /> : .. <br /> EL�C7"Iad�s4�L�,P���C�7'A. �1 19� .,:..� . .. T.�,...... : .. <br /> ... ... . .. ..:.... . .. . . .._ ... . . ., , :- - <br /> - - <br /> � .... . : _... , . . . ..... .. ... :.:.. . . . . . :. <br /> COPITRACT PR}CE OF WORK:$ C� ��' ' '� � 4� . (sr'�s <br /> NUMBER OF DEVICES(ifi fow voltage):• <br /> F1RE ALARM? ❑YE5 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTIQ�t OF WOR#C: � , � ,�� e <br /> �'�`� � ,, � t ..s "'"'"'� - � � .��t°�lf� n - <br /> •....�:_ ._:., . .._ . . . . . ... .. . .:. ... ...•.. .C......'Y;AC ��1 FO �t{IIA'P ON �� : . . .... . _. . . . .. _ - . <br /> :.....: _._ . _ _ __ - <br /> _ ...�-. ., . . ..:._. .. <br /> �'::�._..:. ::: .:.- ... . - � _ � _ _ - <br /> . .. �.. .. .:.: ._.�.: :: ..::.... :::: .:...�ON. <br /> : . <br /> r,.:.'�'. N � s::...._� ..,.: .. . . . �.. _ . : .. :. <br /> OWNER NAME: ' TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srReer /� `,�—° �(' � � <br /> (���'• CilY � STATE ZIP ��� <br /> OWNER PHONE: OWNER EMA[L: <br /> CONTRACTO.R NAME: ,S, `Jr �^ <br /> CONTRACTOR ADDRESS: s-rRe�- � �� / ���� <br /> � � q7y STATE ' ZIP - � . <br /> CONTRAC'fOR PI-IONE: � CONTR�ICTOR EMAIL:� � '."�� � e a�` +`� <br /> CONTRACTOR LIC,#(REQUIRED): ��� CITY O�EVE� ETT US(NESS LlC.#(REQUfR <br /> PRIIVIARY CONTACT:��Cl OWNER '�ONTRACTOR y�~CI OTHER(Please Specify)� <br /> CONTACT NAME: GONTACT PHONE: �� -� �.. <br /> �� CONTACT EMAIL: ` � � � , <br /> AGREEMENT.•T hereby certify tha l have read and examined this appiication and knowfhe same to be true a orrect All provisions oflaws and ordinances governing fhis <br /> type of work willbe compieted whetherspecified herein or not. The granting of a permit does not presume to g�ve authority fo violate or cancel the provisions of any otherstate or <br /> local law regulating construction or the performance of consfruction. Thaf!am authorized 6y the owner of this property to perform fhe work for which application is made and! <br /> comply with the Sfafe Contractors Lav✓98.27 RCW arzd 29E 200 WAC <br /> ' Crfy of Everett Official Use Only <br /> FEE <br /> . �� s -- <br /> PERMIT# ���� ( r �� <br /> 1�' I rl L ��71 <br /> , t ,�� �1� <br /> Owner horized Agent Signature Date (Revrsed 90/9?J2095) <br />