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12/19/2017 07:44 FA1 425 377 1976 RE1 ELECTRIC �001 <br /> ���������� ��� I� ��F' �Yl�r����lrl <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 � FAX 425-257-8857 f (�) everefteps@eve�ettvaa.gov � www.everetitwa-9ov/permits <br /> PRA.lEGT �9TE i�6F4R�1flB�1'tON <br /> PROJECT ADDRESS: , C �lG � ' � 1�CJ l -G l � � � <br /> SF <br /> 6UILDlNG AREA(if residential, new construc4io3�, re�nodel,or addition) � �p�yMERClAL <br /> �,� y <br /> BUfLDING i"YPE: ❑ SFR-DE7ACH�D ❑ SFR-ATI�ACNED ❑ DUPLEX �NiULT!-FAMILY-#OF UNITS:��_ <br /> USE OF SUfLDItdG: �y�;i�f" �%7 � <br /> E E �'F�6C AP�L9CA'TiO� �NFORM,dS`�lON <br /> CfJNTRACT PRICE OF WORK: � � �� � �� � <br /> NUfViBEFZ OF DEVIGES (if low volta e;. <br /> FIRE ALAf�tIW1� G�YES �PlO-� <br /> ASSOCIATED BUILDtt�G PER�iIIlT#�(if a plicable : '��� - ✓� .�J.�� i <br /> . r / t�✓�i � /i� : <br /> D�SCRIPTlOP1 OF WORK: '�� �� �� � � <br /> l'��ilJ� /'i>i �'G� �� G.�,,�- J �G � - �'=/Gr ..�'`� �i� �,� <br /> ; � � <br /> ^ �: ��,t- C'�= ��v� f��' ► <br /> � �F �!��% <br /> C�t+�'TAC"F' 6N�0�2F�6A"i'I�t� <br /> �ENAAlT F1AME(If Commercial): �.� 'i ( G ' . �� � <br /> OWPJER[VAME: % � r!� .�• '�• "` – <br /> ^ ��7 � � ,' // <br /> 01fliPdER @iflAlLING AlaDRESS: sr�Ee? � ' _� �,�`� ��� �/ I�,'L�-- �!l�i� / <br /> � ,,f� 'i sT�re j z�� � J! � <br /> CITY -��/L��/' � " / <br /> � /' �,� ,(� �i � .. � ��G+ �.e_ / �• ,G�� <br /> OWNEI2 PIiONE: � � � 'l>L)_7 -�UL 2�' _- OWPfER EMAIL:Li� : ��/ G (! - <br /> COfdTRAGTOR ADDRESS: 1'9112 18$h S� i+�E <br /> STFT� ,_ (!'� <br /> I.alte Stevens i��9�258 <br /> coNrRACTof2 PFioi�E: 42�-422-'Y744 COPdTi�cl"oia �ntBAiL: Priecac� �nail.caan <br /> GatdTRn.CTOR►.tC.# R�XEL.�S962Pl�$ CITY OF EV�RElT 43L1SlfdESS LIC.�fi 0�4�749 <br /> pi2�fVI,4F2Y COPITACT: � OWNER Q CON�RACT�R ❑OTHER(�'fease Specify) <br /> CON'TACT P1AP1tE:Robin �ZiecDcs C0�1'fACT PNONE : 425-4�22-1744 <br /> CONTAC7 E�1AIL: a�ri�cks@gmail.corn <br /> AGREEG9F_NT:T hereby certify thaf I havo read and examired fhis applrcation and Icnow 1he same ta be true and correct. AI!prnvisions of laws and amfnances governing fhis <br /> type of worf<�vilJ be completed whetner specified herein or nat. The g�ar7ting of a permit does not presume to�ive aufhonty to vio/ate or cance�ihe provisions of any other siate or <br /> local law regulating constn�ction or fhe performance o;construction. That 1 am authonzed by fhe oNmer of this property fo perform the work for which application is made and I <br /> comply v��ith fhe State Contrac4ors Lav✓18.27 RCW and 29^.200 V✓AC. City of Evere!t O�Ci81 Use Only <br /> FEE <br /> �� . \ � <br /> � <br /> PERMIT# <br /> / * � ���� — \ 1 � <br /> '/ _, ��' �G�' - /„2 �i�",f�'� � <br /> .,� ,. <br /> Owner/Authorizod Agent Signature <br /> Date (Revised i0/9�J2095) <br />