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I���� '��� ��� �� �� N�������� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-88�0 � FAX 425-2�7-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits <br /> ,, _ <br /> . .. <br /> _.._. <br /> .. <br /> , .,_. <br /> _ ' : IPR�JE�T SITE II�I�OitiViA7'ION:; <br /> PRQJECT ADDRESS: L� r,/�S T tJ S% vt _ T S.ZO <br /> BUIL.DING AREA(if residential,new construction, remodel,or addition) 2 U 40 SF � <br /> BUtLDING T(PE: I�SFR-DETACHED ❑SFR-Ai-fACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: �,�/��r �..q.,v�i`y Z -S D,r'.��CL`_ <br /> ._ _._._ _ _--- - <br /> ,, ; ;. ,: . .. .. . <br /> �.: <br /> � CAL APPLICATION 1NFORMATION <br /> CONTRACT PRIGE OF WO :$ <br /> NUMBER OF DEVICES(ifi lo oltage):� <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPT(ON OF WORK: � ,�� — � .✓ sw�,— — ;�E .vv. <br /> o — ' - <br /> — — � D <br /> � .. c <br /> c.L 5 S.✓v .�v L- w/S <br /> . .. <br /> ..... , . . ..... . . - <br /> :. <br /> . . . _.: . _. :. . CONTACT.INFORMATION .::. - - <br /> OWNER NAME: � TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: s-rReEr y� � % <br /> � - CITY L' ✓/��2,�� STATE ZIP <br /> OWNER PHONE: S- -c� - 6 7,Z. OWNER EMAIL: ,C,�� <br /> CONTRACTOR NAME: <br /> CONTRA.CTOR ADDRESS: srReEr <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRAC70R EMA(L: ' <br /> CONTfiACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT:WMI,gI OWNER Y��CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: GONTACT PHONE: ¢Z�J,-, v�- <br /> � /.N� R�� �� CON7AC7 EMAIL: � � �L <br /> AGREEMENT.�T hereby certify that 1 have read and examined this appticaiion and know the same to be true and correct. Al!provisions oflaws and ordinances governing this <br /> type of work wil(be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cance!the provisions of any other state or <br /> local law regulafing construction or fhe performance of construction. That l am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Confractors Law 98.27 RCW and 296.20o WAG. <br /> City of Everett Official Use Only <br /> FEE <br /> ' r ��_ <br /> �� p <br /> PERMiT# <br /> i�-- � t�.�,� --- l � g <br /> �/� - � <br /> Owner/Authorized Agent Signature � �Date � (Revised 90/12/2095) <br />