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. /az��- ��7���. <br /> �a����.���� ������ ����������� <br /> CITY�F�VER�7T PERM]T S�RV[CES <br /> 32��CEDAR S1"REET, �V�RE7T,WA 3820'I � <br /> (P}�42�-257-8810 � FAX 42v 257-8857 j {E} e�eretfeps@e�erettwa.gov� www.everetiwa.gov/permifs : <br /> i <br /> ,,: . - - - - �t--� _ � , . . . • - . - <br /> 01 <br /> .'�' ..+.: <br /> �O' <br /> ..R <br /> y :N �,,,._, <br /> . ::S <br /> 'GT.. � '.� 1��-. <br /> - �1�RO:DL. �. ,�►.- - - <br /> _ :�.,:�:•=::: <br /> .:�: - - <br /> PRQJECT ADDRHSS: , � ' <br /> � <br /> BUILOING AREA(if residentlal,new construction, emodel,or addifion) 5� <br /> Bul�.gfN�'t�rP�: Cl SFR C7ETACHEp ❑sFR ATTACHED C] DUPt�EX CE MULTI-�AMILY-#O�UN1TS: �caMMERCIAL I <br /> us�o�suiLntr��: ��'� G �V�iP� � <br /> -s,.. - - - ��,• . _ :�:, ', <br /> ,;,. :;1.. <br /> ..ir�oi�� :'� <br /> . . ,o.. .RM - <br /> ._�_ .�. � <br /> �,pLIGAY� �;�.. <br /> ��GTti'[C� L�A� � �, Q .��:::. <br /> ,��� .19�.. t.. - <br /> ;:�..� :�... <br /> ,�'....,.;..,...,..:_.._._:: <br /> GONTRACT PR10E��WQRK: � � <br /> Ntf1U1BER OF DEVIC�S{if low voltage:� <br /> FIRE ALARM? �I Y�S NO <br /> ASSOGIAT�D BUI�,p1NG�ERMIT#{(f ap iicable}: <br /> A�5CRIPTION O�WORK: � <br /> � .•4 ::�. _'. - . ' • : �. �� ' � - ;GOI�T.ACT'1N�ORN1%�TI�N:��• � . .. . .. . . . .. :t..t-.. <br /> ':1... .� �.:w..�. . :k. _ -_ .,. . ,a. :e �•.. . •. .'.'._ .� . .. . <br /> p��R�pp��: � TENAN7 NAM�(If Cpmmercfal : � <br /> pWNEEZ MAtLIh1G ADDR�SS: srae�r' �X ' <br /> ClTY �.Gr STATE r�!/f I l� "���I <br /> OWNER PHONE: OWNER EMA[L: <br /> CONTE2AC70R NANl�: � IV � � <br /> CON7RACTOR AqpRESS: sr���r �O �DJC <br /> ��n 1� /L � �A�/'� z�p 2 <br /> CONTRAC7ol2 PHON�: 'rj"Z 7'"� �� CONTRACTOR ElVIAIL: /e1 • ,IY)�'�1� � • C�� <br /> CONTRACTOF2 i.CC.#(R�QUIRE�: (.�,�rV4� Oz, CITY���V�R�TT 13USW�SS L1C.#REQUERE�}:�Q <br /> Pt�IMARY CONTACT: ❑OWNEFt �CONTRACTOR Cf OTFlER(Please Specify) <br /> CONTAC'['I�AME: CONTAGT AH4NE: �Q�,^73 b"iP J�7�p . <br /> . ��'�J N j r'J C,�.LJ�/1I CON'FAGT�MAiL: p�f�J1�I S.CK�a�t10 �!�"W't T. L�.otYf <br /> At3R�N1ENT 7 hereby certily ihat 1 have read and examined fhls appHaatlon and know tha sama to be true and correct A!!pravfsions oflaw,s and ordinances governing fhls <br /> (ype of work wJilGa aompfefed whefhar speclfred hereln ornot 7he grenfing of a permif doas nnt presume to gJvs aufhw/ry fo vlolate or cance!fhe provlslons of any ofher state or <br /> loca!lawregulaHng oonstruction or the pe�formance of canstruction. That I am autho�ized 6y the owner of thfs properfy fo petform ihe walic far whlch applfcetlon!s made and 1 <br /> anmply wlth the sfafe Confracfors Law 18.27 RcW and 29a.2oo WAC. <br /> Cify of Evereff O�cle1 Use Only <br /> �EE Qa ' <br /> ' ���7 r-- <br /> PERMlT# <br /> � ��� — t�3 <br /> �a��se��a,���o,�, <br /> awner/Au or zect Agen Stgnature Date � <br />