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. ,� 'Zs22c���90� ��3lS� <br /> �L���-����� �����r .��� �,����r� <br /> CfTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8890 � FAX425-257-8857 � {E}everetteps@everettwa.gov� www.evere#twa:gav/permits <br /> ,. _ ..�.,.�- - . _ .. _ <br /> _ - . . - :J-�T�.S�TE�� NFORf~ AT10N;=`��� • • ._.. - - _ <br /> .,._.,. : .,: <br /> �RRO E 1 .� .�ll. - <br /> _ , .. . „ ;. <br /> ,.. ;: . � -.: . ...•` •• <br /> ..... <br /> . . <br /> :.. .:: <br /> . <br /> . .. . . <br /> . : ,. <br /> .... <br /> . . <br /> . <br /> . . ,.�...,;.::� <br /> ...:.>�:. <br /> .:...:.,.,,_..:..:.:..�...,.....:.: .... ... . ,._ ...,... ._.,.._�,-•::_...;.. -:; _ - �t. <br /> PI20JECT ADDRESS: ' 3 �7^ L �O.� <br /> BUILbING AREA(if residential,new construc6on,remodel,or additlon) SF ' <br /> BUILDING TYPE: ❑SFR DETACHED ❑SFR-A7TACHED ❑DUPLEX ❑MUL71-FAMILY-#OF UfVfTS: �COMMERCIAL <br /> USE OF BUILDING: OET J�G EVE,P.E7T � <br /> � . . . � - - - - - -- - - -•OI�• •� - - - - <br /> ,. . .._.,: :•-•, <br /> .Gt��RfCAL�;AhPL1�AT10N^� <br /> ��I�ORIIAATI <br /> ��LE T �1 <br /> ,..�:....:. .: ::::. <br /> ..... <br /> ... <br /> . , .. <br /> . :.. . <br /> ,....... ... . ... <br /> .:. <br /> . .�„ <br /> . <br /> .... ,. . <br /> . <br /> �.: <br /> .. <br /> . ,: <br /> ..,:. ... . . . .. . .. .... _ - - - - - <br /> .. <br /> . <br /> �.._r�....�. . �-� '.��:.: ...:.. �:_: ..: '.... '�.r:.•':-i'_�:..a•�.r..:'iY.< � __ �� <br /> 'i:yt;.. 3 ......:•..;�.��.. ;..�..�i....t.. •y� ' <br /> CONTRACT PRICE OF WORK:$ o?D OD ' <br /> NUMBER OF DEVICES if low voltage:� <br /> FIRE AtARM? ❑YES �f NO <br /> ASSOCIATED BUILDITIG PERMIT# if a licable: <br /> DESCRIPT( N OF WORK: <br /> .;,� �.. - .1. � � '_ � ' ,GtONTACT.�INFOii1V1�1T10N.•.._ . . .. . _. - � � . .. _ . .. <br /> py{�g���; � TENANT NAME(!f Commerclal): � �j <br /> OWNER MAILING ADDRESS: s�eer �X �j <br /> �� G�- �A�Wi9- �9 /2 -zzo7 <br /> OWNER PHONE: OWNER EMAlL: � <br /> CONTRACTOR NAM�: /C> C� I /v' <br /> CONTRACTOR ADDRESS: srn�r PO �OX <br /> �m� !� JL G� �rA��I' �P 20 <br /> CONTRACTORPMONE: '�j'Z 7''� `7'"7' CONTRACTOREMAIL: . I��rle I �T�� C�m <br /> CONTRACTOR LIC.#(REQUIRED): (S�NL��C "7'D Z CITY O�EVEREI'T BUSINESS LIC.#(REQUIRED):�O5 <br /> PRIMARY CONTACT: ❑OWNER �I CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAINE: CONTAGT PHONE: Z�-73 b"Cp S��p <br /> . •��N�� '�J C�D�/11 CON7ACT EMAIL.: D� l��^J.�le��� 1���VI/�1 T� �.0/� <br /> AGREEMENT.'T he�aby cedily that I have iead and examined fhls app!lcafion and know the same to be frue and correct All pmvis/ons of/aw.s artd ord/nances goveming th/s <br /> rype of work wlll be completed�vhetherspeclfied herein or nnt. The granffng ofa perrnr�does not presume to glve aufhorHy to vlo/ate or cancel the provislons of any ofherstate or <br /> local�aw regulaiing constructlon or the performance of consfructlon ThaE/am authoraed by the owneraf fhls propartyto perforni fhe work for whkh app/fcatlon Is made and/ <br /> comply�id�the State Confractors Law 98.27 RCW and 29E 2D0 WAC. <br /> � Cify of Eve�tf�clal Use Only <br /> FEE� <br /> `�/�, �-� <br /> PERMIT# <br /> �� ��� � �� 3-0�3 <br /> a <br /> Owner u or zed Agen Signature Date (Revised 10/17�209� <br />