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� s��`C9 p A'����I� ���deYM q �11���4"�R�A <br /> CITY OF EVERETT PERMIT SERV(CES <br /> 3200 CEDAR STR�ET, EVERETT,WA 98201 <br /> (P)�425-257-8810 ( FAX 425 257-88v7 i (E)everetteps@everettvva_gov� www.everetiwa.gov/permits <br /> :�:..:.: . . .,.. . - - - - - - --- - -- .. <br /> � �.�-,� � .. 1PROJE�7':;517'�•�II�IFORMA,TIAN;'�� � _ <br /> PROJECTADDRESS: 2 k� � � d� �- _ SE. <br /> BUILDING AREA{if residentia(,new consfruction,remodel,or addition) Z� SF ' <br /> BUILDING TYPE: ❑SFR-DETACHED �TSFR A7TACHER ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMi1/IERCIAL <br /> U5E OF BUtLDWG: S'fi 2 • <br /> �� � ELEGTRICAL APPLIC.ATION��INFttiR1NAT10N� `�� <br /> ,, . . . <br /> : : <br /> +-,:c�.. . ::.-.. �_.:.. _'._...:..�..a.::'::': ...:: `:_: .M;S:1�.+c.�.a:Ai� ' u=i�•t _ _ <br /> CONTRACT PRICE OF WORK:$ �7��fj • <br /> NUMBER�F DEVICES(ifi low voltage):� <br /> F1RE ALARM? ❑YE5 l�(NO <br /> ASSOCIATED BUILDING PERMIT#Cf applicable): <br /> DESCR(PTtON OF WORK: }Z2�eJ �`r� -e_k-c` �`fi�'c� �8'w-� ��"�� ,.(�e <br /> � �v�: . <br /> ;;..:.... ..:.. ..:� . . . . . - , . . . ... .. . ... , - <br /> .... ..�..:�. ._ � ��: � _ . . . - <br /> �.--� � �� � ' - <br /> .... <br /> � .._.1..:-... .-.�.:.�'. i":�' . i : ., . . ": ..�.��., . .0 - ' � <br /> ... .. . .a .:.«� ' : <br /> ... <br /> :�'.�;::.COMTACT INFORiVIATION:;::.:� .. : � �� <br /> OWNER NAME: �C'�� CC�«�.r-$ TENANT NAM�(if Commerciai): <br /> OWi�lER MAIL(NG ADURESS: sreeer <br /> CIIY STATE ZIP <br /> OWNER PHONE: OWNER EMAtL: <br /> CONTRACTOR NAME: � , �� �a'�'E'� F.�.,�'.��Y�K � C � <br /> CONTRACTOR ADDRESS: s-rR�r �ZZ��t ��'�^�S �c�-e <br /> ��„r w�.o--��--'�- �A� '�✓� vP`� �2 a '3 <br /> CONTRAGTOR PHONE: Z�"..j��'�'`�-(�S� CONTI3ACTOR EMAIL: 'L��tM � �,f e d�C.:�e.q'.��*QC. �Ctq c.�..� <br /> CONTRACTOR LIC.#(REQUIRED): GITY OF EVERETT BUSINESS LIC,#(REQUPRED): QS�'&`0 <br /> PRIMARY CON'TACT: ❑OWNER ��CONTRACTOR yHCI OTHER(Please Specify)w <br /> CONTACT NAME: y GONTACT PHONE: ���— `,C'c��r' -(-(3g� <br /> , � in� '�-f G��-ts2 CONTACT ENfA1L; �i' u.� 'C �.i"'+ Ca.rci�r ����� �y� <br /> AGREEMENT T hereby certify that I have read and examined this application and know fhe same to be true and correct All provisions oflaws and ordinances goveming this <br /> iype of work wilf be completed vuhether spec�ed herein or nof The granting of a permit does not presume to give authoriiy to violafe or cancel the provisions of any other state or <br /> locallaNr regulaGng construction or the performance of construction. That l am authorized 6y fhe owner of this properly fo perform fhe work for which application is made and l <br /> comply�rith ihe State Contractors Law 98.27 RC1N and 296 200 WAC <br /> City ofEvereit O�cia!Use Onty <br /> FEE <br /> � ���°� <br /> PERMIT# . <br /> ��-,�'��-�- �-2�- � 7 � �1��'„ --� <br /> Owner/Authorized Agent Signature Dafe (Revised 90/92/2075) <br />