|
%29z�-�8�r a�� ,
<br /> �����`1���,�,1� ���1i���` ,�,�f��,����`N�� .
<br /> CtTY OF EVERETT PERM]T S�RVIC�S
<br /> 3200 CEDAR STR�EI', EVER�TT',WA 9820'{
<br /> (P)�425�2�7-ss�o E FAX 4.2�257-8857 f (E}everetteps@evereitwa.gov� www.everettwa.gov/permits
<br /> :�y�' ._' �:�5.�• :i�y �gy: .y�._..w. �+:�.+�rp...�• •1' � y
<br /> _ s 1?'; '"�' { � ,�-^r "<�t;� . -'T,^a;a�` • •..`y'r.
<br /> ,.. '� a ��I �Q'r_'•`�;'.��.�..��,.,�..,.�..,��k_ A'S'�O� �a ...f. '. `'_;".
<br /> � � �1�' !1E �� -:"t''� - �' +.fi•�
<br /> k5' o•1'G-: ..tv.J..� •.5:•} .�.C*dh4�- fs.h+:H.i'1+.^R'�.M'n S:q3. 4•+r:a:Wt;z�.t �il:r�� .f•:•:�+J�
<br /> PFtOJECT ADDR�SS: O'�J"�„ �.'"�z.
<br /> $iJ[1.�IMC AF2�A(ifi residenfial,new consfruction, model,ar add€Hon} SF '
<br /> BU[LC�ING TYPE: L7 S�R D�TAGHED ❑SFR ATI'ACHED ❑DUPL.F�C C{MUL,'f!-PAM1l.Y-#�F UNITS: �COMMERCIAL. �
<br /> us�oF su�r...��r��: OE�'ll�G �1���'iT -
<br /> a,�„u •:{ti;i''2f�� x:L'•;vr.14aY'y prn1f.. yr`.t.. {� .■n+v C.. .ny$'`,��H:'i:��y�'.•y;�`�aX�YY:7h14 n���,�..rc,.� •
<br /> ,�=.:.�::': :,:_: � - GT�{�■�,�'/�L-•��'�p�,�?����i31#J ■OM 1 ORNl1{,T�O�!•;�;�. :^: Y-`.:�s� v��� �'�,:,:��
<br /> ;:wv,4 ceei.i-_a: .•i: .w��rawa:Pv7-mrk[�kor..Gay„•.,i�vr.+i�7�:i.��i�ti..er r_tun..�J, . •:re," .•':.�{,•s :�.Y� �
<br /> >o.w �LYR .m• :i...ff�`�..�.:.�:.ax ,t.
<br /> CONTRACT 1'R1C�OP WORK:$ •
<br /> NUi1tfB�R O�DE1l[G�S{�f 1ow voIf e:�
<br /> FIC�.E ALARM? C1 Y�S NO
<br /> A5S�GIAT�D BUI�,131NG P�RM1T� i�a licable:
<br /> DESCRIPTION OF WORK:
<br /> � f .
<br /> �:z. -�- . . • . • -•�--, ., ,:r�; . . , .. _. . . _ -, . _.. • .."',;
<br /> � (�O ACT'IN�ORMATION:'�'.' `" '�
<br /> , ~::,-. � - ' - :� ••� .���....:.� �.�•x•.� � .��.:�
<br /> OWPtER NAM�: 7ENANT NAME{fF Commercial}; �'LC�}�
<br /> OWM�R N1AI[.ING ADDRESS: srne�c �OX � � �
<br /> CI3Y L''� 8`fATE�� Z1� IZ "�L.'�
<br /> OWN�R PHOt�E: OWN�R�MAIL:
<br /> CON7RAC'f0�2.NAN[�: � I,� /�.�
<br /> CQMTRAC'�'ORApARESB: srr�r �l7 ���
<br /> C1iY � I� �F�V1f� T1P
<br /> �Q��rrzAcroxpxQr��: �2 '�~ � caKr�ac�rQRe�rra��.: f�-R14 /y}�'—� � ! , L'D/7')
<br /> coNTt3Acrort�[c,a����Qui��}: (?�l1/ C '�D CCfY OF EV�TT'F�USII�I�SS LtC.#(REQU1REp}: 0
<br /> FWN[ARY CONTACT: ❑OWNER �CONTRAC7'OR ❑O7HER(Please Specify) •
<br /> cat�Tacr r�.a��: coKracr pHOHE: �p(p-73 6�(�5'�lp �
<br /> . t��'!�Jl�15 L�'.,�b(�tl • cor�rAcr�n�v�: p�ly�I S.CK��.t.l� k'1�"w'!T. L�,o%Vt
<br /> !10l7EEA9ENT'T hereby oertify�iat!have read end exarntned thls applfcaHon andlmowthe same fo be frue and correct A!I provJsions oftaws snd ordinances goveming fhls
<br /> fype of work wHlbe complefed whetherspec�i'ed hwsln ornot The g�t�fing ofa pe�n�daes rmt presume fo glve aufha�lyto violate orcanca!fhs pratrislons of any ofher state or
<br /> locallaw reguls8ng constnrcl/on oriha pe�formance of consfrucflon. 77raf 1 am authorized by the owneroffhTs propedyfv perform fha wwk for whlch applicadon is mada and/
<br /> compty 4viTh tha Stafe Confracfors laW i&,27 RCINand 28&2�o WAC
<br /> CltyofEiremtf�c/a1 Use On1y
<br /> FEE �
<br /> .�'�- 9�. ��
<br /> PERMIT#
<br /> ��-���1 � ��-t2 - e°� 5
<br /> OwnerlA or edAgen Signature Date (Revfsed 9Q/12f20f5}
<br />
|