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<br /> �. CI"fY t�F EVER�TT P�RMIT S�RVIG�S
<br /> 32�1f���QA�I��TFt��T, �V�.l��TT, W�98�(?�
<br /> (R)4�5-��T-£3$1t� ( FAX 4��-25'�-$�57 � (�)ev�r�fiteps a�ev�rettvrta.c�c�Y� Yvwvv.ev�r�tkw�.�qu/p�rr��it�
<br /> P�t�1,�EGT SiTE fNFt?itM�hT1.C1N
<br /> PRpJECT ADDItE3S: ��/ " lr� �'17' �'i .�'�.�- �l'L��i�m ��, �.,� ��, r�t��
<br /> �UlLpftJG AREA(if resid�ntiai,new Gonstruc;tiqn, remodel,ar additioi�) �f���� SF
<br /> , . . .
<br /> F3UILC?ING TYP�: �1 S�Ft-pE7`AGM�p CI SFR-ATTACM�Q �I DIJPLEX �1 MULTI-FAMILY-#QF 4JNI't`S: CQMA4�RC,lAL
<br /> �seaFsui�p���,.. ���,rT'�� �LIN{'�.- . . .
<br /> _
<br /> ELECTRICAL-APPLICATIt?N iN�ORMATION
<br /> CQNTRACT PRICE QF WQRtt: $ ��. ��'��f t�<..�
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<br /> NUIViBER QF DEVIGES�if Iqw v4liac�e : �'��
<br /> -�--�---.—�. ,--
<br /> �IR�AL.ARM? I�YES ° NO
<br /> A$SOCIA7EC!SUILDIN�R�RMtT# if a plicable): ,�'� �a�(t" �f�`�f
<br /> �-�-.-.,,�.�..--.-..�.�._..—�. ll
<br /> ' Sry it�'Y�r���� {,�Y'��[/+t.,.� 9Y( �� y . ... s � i_ � � r� . /�i��G ti�J("� .
<br /> !?ESCRIP7IQN (�F WQRK: r� . . < �,���-,,.• �C�r .��'' ��{>it�fv %.�l�� � �,.��"� � tf, .
<br /> �"`r';.�.!�i('I� t lJ y:,.1::� ��1 L�'�;ry��'� l�`f.�(Y�.L�..-� �'�Q1�";vt'n j,'�C�r<i ��:; ��s L r:-<��.... �G,�>!',�fr:'r'�-.i�1���(` ,.'Jt�fL3 rbl�lt`-�'" Jd���%�
<br /> =�{%`�ij��e�L/ f"�'G``/.3`��'�..-,.�`!.L'i t�-���C?.S r 1 tV l� S',�'dZ U�i�t.
<br /> CONTAGT INFORNIATiON
<br /> pWN�R N�1M�: ����f��'�!f f t���,�1 rI�' (���t�f�-- TENANT NAME If Commercial): ��'��
<br /> pWNER MAIIiNG ADDRESS; sTRear �l'.�j�1 �(��P� �'� �SG�-
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<br /> cr�v ��/�1.,.�`J`j' sr�� �.�.,,�`i z�r� �qt���`f
<br /> OWN��i F�MCiN�: `�2 .�" `�.�'I � G G��✓° QWNER�MAIL:
<br /> CCINTRACTQRNAME: ����«.Tf1,�,I�l� I�'�G'C.���,./4.?�C.., L� C.... , .
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<br /> CONTRACTOR ADpRESS: srr�e�r ���. �"��1C ,��!��'�
<br /> _ cn,v ��r�/f'c: � : srnT� � ziP ��"'!.?f I
<br /> CQNTRAGTQR PHOME: ��C ... '"�:�C _ �>•/t.�a CQNTRAGTOFt EMAIL: ���9�t�,•�,'1,��G-h7'�l,�t.�i����"G'fyLIC-�� . �ti.CsM
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<br /> CON7RACTpR LIC.#(REQUIkED). /�`���Tt`���- ��'�C�� CITY OF EVERET7 BI�SIN�SS LIC.#(REQUIREp):L�J��1'�"
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<br /> PRIMARY CQNTA�T: CJ QWNER CQNTRACTQR �I C7TtiFR(Please Specify}„�
<br /> con�rACT r�,�r��: � � ��� cr�r�re�cT QN4ra�: ?��� - �.�'�;� �?������ ��
<br /> ���d7` ��'��1�,.��!�"�,� CQNTAGT EfutAIL: ,�-"�� ��C' L�'..;�Gh.�{Pi'rrI<,. f��t�?"%,-,CyQ�. •f.:.��1'7'
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<br /> �tGRE�MENT:T horeby cerNfy Yhat t have read and examinod this appfication and know the same to be true ancl correct. Al!pravisions of laws and ordinances gcaveming this
<br /> type of 5vork wi!!be cvm�l�tcd whether specified herein pr nqt 1'he granting of a pr�rmit c�oas r�at presume to give acithorify ip violcite or cance!tha provrsions oi any other st�te or
<br /> /ocal!aw regulafing consh�uction or tfie performance of canstrciction. That 1 am authorized hy the ownar af this property tq perl�rm the work lor which applicatioir is made arrd!
<br /> compiy with the State Contrackors Law i8.27 RCW anU 296.200 WAG.
<br /> Gity of Everett pf(icra!�Jse Onry
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<br /> pwner(A+uthorixed Agant Signatyre Qate (Revis�cl 1p/l2/2415)
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