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��z�z5- ��2.�,�o� a�� <br /> ���������� ������ ��������-��� <br /> C1TY O��V�RE7T P�RMIT SERVICES , <br /> 3200 CEDAR STR�ET, �V�RETT, WA 982Q1 <br /> (P)�425�257-88'10 J FAX 425-257-8857 � (�)everetteps@everettwa.gov� ww�nr.everettwa.c�av/permits <br /> _ - .4;. .,y._ -- ' -.•Y... �r4..a ''.: •<a - .;r: ;�r.�•. - <br /> . �s�~ �`�,t <br /> ..OJ���'i'�.S ..�<,�, <br /> R � r 1� ;.� .'�F. <br /> �� �. <br /> `�,�.'�. .�, <br /> .�.. ?�+-- <br /> A:�nl��Aw ti.S:..:F+.�.e+:fi.A.�.i.. - <br /> pR,O�HCT ADDRE55: ' <br /> BUII.DlNG AR�A(if residential,new constructin remodel,ar additfon) SF � <br /> €3U1LB1FVG TYP�: ❑SFR RETACH�CI ❑SFR ATt'ACHED ❑DUPLEX I�MULT[-�AM1LY-#OP UNITS: �C�MMERCIAL i <br /> us�o�sur�ir��: dE�'1�G �1/�,P�`tT . <br /> _ ,.�,. �..:..�_� - - •.t•; �.��; •r,,. :•�z�;�-:�:.:•�. -.,,�. <br /> ;.:t...�. .w�, . . .:' - <br /> ..0.. <br /> ,,`.. <br /> �0�� ��TB <br /> N N� <br /> -.a„ �,0. R�:, _{,{: :;;:�: <br /> �Q.. c.'_i�APa�:� A�`i�A �N� A�. <br /> rE�':E TRI � �� -��:,�:.:,<:�.;;;,:, <br /> �. .R?� `�L4'.:�:�:.`:.. .:i:.. <br /> v'Yi<iGl_�ti44�...••J4�..-.:��i'•i'.•{:"t�l•.Y.`..•R!•.l.^a�... iKL+ _ <br /> ..SL,; - .-�.�.c.u•w . <br /> CONTRAGT PRIC�OF WORK:$ DD ' <br /> KEJMBER OF DEVlC�S(ifilow uo[tage :• <br /> PI�2E AL.ARM? ❑YES NO <br /> ASSQGIATED�UIl.�?ING P�RM�T#{ifapplicable): <br /> p�SGR11'TiON QF WORK: <br /> , - <br /> �y �,: :,.. . ' •. ._ . �GO[�'1?ACT.�INFORNIATION �. . . .. . __ � � . .. _�,_�. '�t <br /> �.�: ,�.� •. <br /> ..,.. �: _:,. .. :-.. _ .. ..: .-......�� .:: ., ,.. . . ... _. .:. .. _ <br /> OWN�12 NAME• � T�NANT NAM�(If Commercia[ : � <br /> DWN�R MAILING ADD}2�SS: s��r Q�X 3 � <br /> crrY �'` srn�W�' zi� �2 -ZZb7 <br /> OWNER PHON�: dWNER�MAIL: � <br /> CONTRACTO.R tJANfE: � G�L� I � <br /> CONTRACTOR ARDRE55; srx�' PD z7D�C <br /> CITY � I� [./ STATE�� ZIP L.Lf � . <br /> CONTRACTOR PHON�: -2 �- �� CONTRACTOR EE4�IAU..: f�-l�!. !t?�`�� l l7"� CD/�7 <br /> CONTRAC'fOR LCC.#(R�QUIRED}: ,�.��N� "'7'Q�. �1T1�0��VEE7�TT�USIIVESS LfG.#[ftEQl11ftED}:��'„}�' <br /> !'R[MARY CON7ACT: ❑OVMlNER �1 CONTR�ACTOf�' C!OTH�R(Please 5pecity) <br /> CONTAGT NAME: CONTAGT PHON�: 2�,-73 b"lQS`�-�p <br /> _ ��N N 1� L��.b{ril CONTAC7�IVfAIt..: D� 1�lS.CKDI.tJ 0 f:lF'w'1 T. LI.Dm <br /> AGRFEN7ENT.-T herehy certify thaf 1 have read and examined thls appikatlop a�d know fhe sama fo be true and conect. Al!provisions of hatvs atxf ordipances gnveming thls <br /> iype of work av!!I be completed whether speoihsd herein or not The g�anting af a permR does nof presume fo glve authorllyfo vfolate or cancsl the provlstons of any afher state or <br /> loca!lawregulating consfructlon or tha performance of consGuction. 7hat!sm aufhorized by tfre owner of this property to p�farm fhe tvork for wfiich apglicafion is made and I <br /> camplywi7k ihe State Contractors Law�8.27 RCLV artd 29&20o WRC. <br /> City of Everetf Off'lcial Use Only <br /> F�� <br /> . -��3, �o <br /> PERMIT# <br /> _I � ,���t - C� <br /> OwnerlAu or zed Agen S(gnat�tre Date (Revised 90/12/20�16} <br />