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���������� ����a� �������n�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820� <br /> (P)425-257-88'10 � FAX 425-257-8857 j (E) everetteps@everettwa.gov� www.everetfwa.govlpermits <br /> , .. ._ <br /> , : <br /> : .: . ������r�o��ar�����rr�����-:�: � � ��= � 't��+; �.... <br /> . . <br /> ..:., .. ..._ .... .: .. . ... .: .:... . . .. .. . . .,. <br /> . <br /> . ..: . � .. ...... . ... ... �-:.�: <br /> . . . : <br /> ... .. .. .. , - - <br /> PROJECTADDRESS: �� ` , `� _ � 6 9��� t <br /> BUILDING AREA(if residenfial,new construction,remodel, or addition) �� ' SF ' <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SER-ATI'ACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> � � <br /> USE OF SUtLDING: r �- ` <br /> -� ..:..:..... ..::.:.............,:....,_<..:...C 1�AP����A7'IONI�Q� �OIZIIII..... �OIV � - -- - <br /> , . .... ..., . . <br /> . . . .. . ELEGT'981 �-�# . . ._:_ .� I�.. .,.. d�`i' .'.:: . : .:.: <br /> CONTRACT PR10E OF WORFC:$ ('QQ � <br /> AIUMBER OF DEVICES(ifi low voltage):� � <br /> FIRE ALARM? ❑YES � MO <br /> ASSOCIATED BUILDING PERMIT�#(if applicable): <br /> DESCR(PTt�N OF WORi�: '� � I� lY <br /> ...;.-.,- ...:, . .__ . . .. . - - . . . _. . . . .. , _ . <br /> .. . . <br /> .,- ...: _ . . � <br /> .:. <br /> . ��'::>::...; :.:_:.':"� _ .:,. .. ,-�: - - <br /> .,. ..:,.. . .<. ... . . ... .. .. .... ..: . . . . .. . ..... . <br /> . . �. ..: .::....... :..: .:CON'i'ACT;INF.ORMA7'ION:,:..; . : . � . . <br /> �WNER NAME: TENANT tVAME(If Commercia!): <br /> OWNER MAILING ADDRESS; srrzeEr �l��� I9�� � � <br /> � CIIY 1�-��8 C�'� ' STATE � ZIP � � a <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ,4 �, �. <br /> CONTRACTOR ADDRESS: six�r ( <br /> ciTM �� � STATE ZIP ��� + <br /> COPITRAC'I'�R PHQNE: "� � ,� % CONTRACTOR EMAIL: � � f Yr� "l` . Q V� <br /> CONTRACTOR LIC.#(REQUIRED): ���1 L�Q` � ����`��!5� CITY OF EVERETT BUS(NESS LIC.#(RERUfRED): ����ae� <br /> PRIfVIARY CONTACT: ❑OWNER� �CONTRACTOR `CI OTHER{Please Specify) <br /> CONTAC7 NAME: CONTACT PHONE: �'' a � '�_ � � � <br /> _ � � ' CONTACT EMAIL: ` ��� i = - �1• (�O� <br /> AGREEMEIVT.-T hereby certi that 1 hav read and examined this application and know the same to be�rue and correct AU provisions oflaws and ordinances goveming this <br /> fype of work will be completed whether specified herein or nof The granfing of a permit does not presume to give authority fo vio/ate or cance(the provisions of any other state or <br /> local law regulaSng construcfion orthe performance of construction. Thaf!am authorized by the ownerof this property to perform the work for which application is made and t <br /> comply with the Stafe Contractors Lav✓18.27 RCW and 296.200 WAC. <br /> ' Cify of Everett Official Use Only <br /> FEE � <br /> ���.� <br /> .1 PERMIT# <br /> ��ti � � �� �� ,� � �� �t � � �� <br /> Owner/Auf orized Agent gnafure Date (Revised 90/12/2095) <br />