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�1L���`�����1� p�l��ll`� .��,����'1(C�I� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everetiwa.gov j www.everettwa.govlpermits <br /> .. .. .... . .. _ . ,.. ... _ .: .� ......._... .. .., _ _ . . . <br /> . . . ���J��"�:�Q`iP� �9���R��`�'��6�;;. ��� `�:�`� "��.�. <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residential,new construction,remodel,or addition) � SF � <br /> BUILDING TYPE: �SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: " COMMERCIAL <br /> USE OF BUILDING: • <br /> ..;., :. . . ... .. .. . ... .: . .. . . .-.:.. ... ... :.. , . <br /> ...._::.. :... ...:. .. .. . ,. ,..,,.� . , <br /> .. .. ����'�'��CA�;����'��'�,�� �������'���� <br /> CONTRACT ARICE OlF 1NOR}C:$ � ' <br /> PIUMBER�F DEVICES(ifi low voltage):� <br /> F1RE ALARM? ❑YES CI iV� <br /> ASSOCIATED BU(LDING PERMtT#(if applicable): � '�.��g � <br /> DESGRIPTIOPI OF WORK; � <br /> � - <br /> ._,.:�� . .: . ,.. - - - . .. . -� - - ._. . .. . <br /> , ._.. . . . ....... .:�. �.- ..:_ �C� 'TAC <br /> _ -. . . : _. . . <br /> .>,. .... - . .:..: ..�:ON. ...:,.T�INFORMATION_-�:. . . � - - <br /> OWNER NAME: TENANT NAME(If Commercia[): <br /> OWNER MAILING ADDRESS: srReEr <br /> Cf1Y STATE 71P <br /> OWNER PfiONE: OWNER EMAIL: <br /> CONTRACTOR,NAME: � `p � <br /> CONTRACTOR ADDRESS: srReEr <br /> ci-n STATE ziP <br /> CONTRACT�R PHONE: CONTRACTOR EMAfL: D "� � <br /> CONTRAC'TOR L[C.#{REf�UIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTAC7': 0 OWNER �. ❑CONTRACTOR CI OTHER(Please Specify) <br /> CONTACT NAM�: GONTACT PHONE: G� "7 P l <br /> �j� �t,t,�v���� CONTACT EMAIL: <br /> AGREEMENT.�T hereby certify fhat I have read and examined this application and know fhe same to be true and correct AU provisions of/aws and ordinances governing fhis <br /> fype of work will be completed whether specified herein or not. The granting of a permit does not presume fo give authority to violate or cance!the provisions of any othe�state or <br /> loca!law regulating construction or the performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the Sfafe Confractors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use On1y <br /> FEE �� <br /> . ,�ZZd , .� <br /> PERMIT# <br /> , <br /> � ��l � 2� b�� <br /> wner/Aufho d g ntSignature Date (Revised 10/92/2095) <br />