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��������.� ������ � ��.����� <br /> ClTY OF EVERETT PERMIT S R CES <br /> 3200 CEDAR STREET, EVERETT, WA 982D9 <br /> (P)�425-257-8890 � FAX425 257-8857 � (E) everetteps@everettwa.gov j www.everettwa.govlpermits <br /> • : �PROJE�T�St7'� INFOR11rlf#Tlt)W_:�,- . <br /> .. .. ... .. .. <br /> . . . . .. .. .. , _. .._ _ � <br /> FROJECT ADARESS: � `� U � �,a��` � <br /> Bi1(LDING AREA{if residential,new consfruction,re odel,or addition) SF ' <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: �OMMEFZCIAL <br /> USE OF BUILDING: • <br /> � - EL' �GTRMC.AIL%#PPLICATION��INFI3R1Mi4T10N <br /> • .� ::. �..-._ <br /> . . <br /> . ., . .,... ,. <br /> .. <br /> ;G,.�. .. _ .. _ . :... ,s.��.:�.�.�;�_......�.:� h_f. t: _�, <br /> _ . . .s.. . :.._. ..: _ ... ��.. . .:. :.: ..:,.�:..,....,,v_.,::,. <br /> CONTRACT PRICE OF WORK:$ . �O • <br /> NUMBER�F DEVlCES(if low voltage).• <br /> F1RE ALAF�M? ❑YES j�0 <br /> ASSOCIATED BUILAING PERMIT#(if applicable): <br /> DESCRIPT[ON OF WORK: ; �(� '� <br /> ::..,: :_ ._::. .._,, . . . . - - . - - - . . ... . -� - - � , - - - <br /> . _ : . . <br /> .::.:.... - -- - p . _ _ _ <br /> . . ....- <br /> ;.�:;:�..: - . .._ _,...- . . - -- .-�..�. --:� _:� M:. �{-� <br /> . �.� .,�.. . ... - <br /> .. <br /> . . .. . : .: <br /> -� ` ;�. �COI�TACT.:INFOR � "� �� _ : = ::� <br /> , ;�...�. :�.:�-:....>. TION::. . . <br /> OWNER NAME: � y� TENANT NAME(1f Commercial): Q�C. � <br /> OWNER MAILING ADDRESS: srReEr <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAtL: <br /> CONTRACTO:R NAME: (� u,r, ` 0�1 � <br /> CONTRACTOR ADDRESS; sraeEr �C C!Z �'— <br /> /� � <br /> CffY � d( 1 i STATE /Q ZIP �� <br /> CONTRACTOR PHONE: �J�1 Z(� CONTRACTQR EMAtL: ~�li � 1 � , �OiVI <br /> CONTRACTQR LIC,�(REQUIRED]: ('�� f � CITY OF EVER.ETT BUSINESS LlC.#(REQUfRED): S (� <br /> PRIMARY CONTACT: ❑OWNER , Nc ONTRACTOR ❑OTHER(Piease Specify) <br /> CONTACT NAME: GONTACT PHONE: �Z '� Z _ � � <br /> � � CONTACT EiV1A1L: `� , �� <br /> AGREEMENT.�T hereAy cerfify ihaf I ave read and examined this application and know the same fo be true and correct At provisions oflaws and ordinances goveming fhis <br /> iype of work wi0be completed whether specifred herein or not. The granting of a permif does nof presume to give authority to vrolafe or cancel the provisions of any other state or <br /> loca!law regulaSng consfruction or fhe performance of construction. That!am authorized ky the owner of this properfy to perform fhe work for which application is made and! <br /> comply with the State Confractors Lav�98.27 RC�1/and 296 200 WAC . <br /> Cify of Everett Officia/Use Only <br /> FEE �� <br /> , � 2�2,°�� <br /> PERMIT# . <br /> - ���,/7 E 1��3" 6C��- <br /> Ow AutfiorizedAgentSignafure Date (Revised 10/1?J2015) <br />