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. �8�s�9�a �6zy�� <br /> ��.��T�IC�41L PER1M��' A,PPL�I�.�TNOI� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8890 � FAX 425-257�8857 � (E)everetteps@everetfwa.gov� www.everettwa.gov/permits <br /> - .�:-. .. . ;,.... _ .,.._ , . . �•��' . - � <br /> � �' :ROJ�4T,�SIT :N...O.1V1,.—TIQ1�•;:'•^ • <br /> -P �:p .:�..:�t ...4�. ;;,� ::l,.:�.���; <br /> .:�: .:,..:. -- <br /> ,..,....;�..:........��.�.,...::. .:.�....... .... . .,........,...�...:..,,._... <br /> PROJECT ADDRESS: �� '� <br /> BUILDING AREA(if residential,new consiruction,remo r addidon SF ' <br /> BUILDlNG TYPE: ❑SFR-DETACHED ❑SFR ATTACHED ❑DUPLEX CI MULTI-FAMII.Y-#OP UNI7S: �COMMERCIAL <br /> USE OF BUILDING: OE�l�G EVG� 1 I ' <br /> � ��ON~I ��ORIVIAT90N. '.'. - <br /> .'�LGTRIC��:`AhpL1t�A,T1 `;;�,` <br /> `�. •M. _�: '�,�.:���� .:s_......::';;;`':'=�. <br /> .��`�� � •4. .�'1. �4<�..:1�� �VL•.. <br /> CONTRACT PRICE OF WORK:$ ' <br /> NUMB�R OF DEVICES if low volta e:� <br /> PiRE ALARM? Cl YES NO <br /> ASSOCIATED BUILDING PERMIT#(if a plicable: <br /> DESCRIPTION OF WORK: <br /> � � . <br /> .:`:�. -�- - . . • . . - � - - - ��O '1'ACT`INFORt1�li4T10N.�.. . . .. . -. . . . .. _ ...: ., <br /> ; . - >�. ..�. ,. - -,_.. <br /> OWNER NAME: � TENANT NAME If Commerclal: ,D�'LC (� <br /> OWNERMAtLWGApDRESS: srRE� PaOX �j <br /> amr �' srn-►� �1/�1' z+� f2 �ZZ�7 <br /> �WNER PHONE: OWNER EMAIL• <br /> CONTRACTOR NAME: I.l � <br /> CONTRACTORADDRESS: sreeEr Pa $�x - <br /> CRY l/! I� G/ STATEI/�/� LP � <br /> CON7RAC70R PHONE: 'Z 7'" �� CONTRACTOR EMAIL: �'/e , /Y��rJ'e / / . CD� <br /> CON'FRACTOR LIC,#(REQUIRED): G�N� "�D Z CITY 0�EVEliE7T BUSINESS LtC.#REQUIRED): O <br /> PRIMAIZY CONTAGT: CI pWNER �I CONTRAG7012 ❑OTHER(Ptease Specify) <br /> CONTACTNAME: CONTACfPHONE: Z�-73G—[pS"�lp <br /> • ��N��S ��d W CON7AC'f EMAIL: D�ly/�IS.C���e IC���/I/�l T� �/� <br /> AOREEMFJVT T hereby cehify that I have read and examined thls appUcaflon and know tha seme to be true and correct All provlsPons oflaw.s and ordlnances goveming thfs ' <br /> fype of work wNlbe completed whether specified hereln or nof. The grenNng of e permtt does not presume fo glve autharlly fo vfolate or cancel fhe pmvlslons oPany otherstafe or <br /> locallaw regulaHng consiructlon ar the performance of�nstmoflon. That 1 am aulhorked by fhe ownerofihis prope�iy to perform the work for whlch applfcatJon Is made and l <br /> comply�lfh the Stafe ConMacfors Law 98.27 RCW and 29B.2Do WA� <br /> Cily ofEve�elt o�clel Use Only <br /> FEE � '%� <br /> C��b .5 ,�� . 1� <br /> PERMIT# <br /> -� E ��� - 12-�-- <br /> Owner a or zed Agen Signature Date (Revlsed 10/12/2016) <br />