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(������.���L� �C�����p�����a�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425 257-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits <br /> . _ _-.. , .. .. . . . ...... .. .:.: _ _.... ...:..:: .. �._._ ..._4r_.�_ ...__ .. . <br /> . ... �. . . ..:....:...::.. . .... <br /> .;��:�. .� . .: - <br /> . <br /> , . .. <br /> , : .: . „ .. . �6��J��'�'�d�'�.QN�����'�'1�fa�. �� .: .:`��:, . - - <br /> PRQJECT ADDRESS: �. �/v�,fv�eS"G�c�.1,-- <br /> BUILDiNG AREA(if residential,new construction,remodel,or addition) SF ' <br /> BUILDING'CYPE: ❑SFR-DETACHED SFR-ATTACNED ❑DUPL.EX ❑ MULTI-�AMILY-#OF UNITS: ❑COMMERCIAL <br /> U5E OF SUILDlNG: � � � <br /> ,.:,-... . ...... .: .•.- ... .. ,, ...--..,.,. ... . .. <br /> .. . . . . -,.-:. . . ... .. ._ <br /> . . . ��EC7"RI�.A�,AP��.�C,A`Pl�t� IIdF�Ril�A7'���d <br /> CONTRACT PRICE OF WORK:$ �,SOO e�'i��� ' <br /> NUMBER OF DEVICES(if low voltage):� <br /> FIRE AL�4RM? ❑YES ❑Id0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): � <br /> DESCRIPT(ON OF WORK: '� �� � � ec. YL � D�e <br /> �.. ..:. .. .. . : . _...,- -�. . .,:. . _ _. . . , -. <br /> _ . . . . .....:..... : .. .: .. ... ..... ... .�.._ . . _ .. .. . <br /> :.-._;. .. . ,.:. <br /> _- - � - . : ._ .:CONTACT;INFORMATION.;..: : - - <br /> OWNEi2 NAME: �,� TENANT NAME(If Commerciat): <br /> OWNER MAIL(NG ADDRESS: srReEr <br /> CITY STATE ZIP <br /> OWNERPHONE: t`147� ����qJ OWNEREMAIL: <br /> ... , .., . . .,. :. � _.... .. .. .... . . . ... . �. ... ,. ... . . . ,,. <br /> CONTRACTO:R NAME: � �j� �'��. 'T`(��C..M <br /> CONTRACTORADDRESS: sTReEr �. \'���-- � �n�� � W <br /> c,Tv y� 2� sTnre ziP�O I <br /> CONTRACTOR PHONE: Z ^ 1�� CONTRACTOR MAIL: ' L' <br /> CONTRACTOR LIC.#(RE4 IRED): � p b� l � �I � CITY OF EVERETT BUSII+fESS LfC.#(REG2UIRED): Z <br /> PRINIARY CONTAC7: ❑OWNER Y ❑CONTRACTOR ❑OTHER(Please Specify} <br /> CONTACT NAME: GONTACT PHOME: <br /> < CONTACT EMAIL, <br /> AGREEMENT.-T hereby cerfify that I have read and examined this app/ication and knowthe same to be frue and correct A!I provisions oflaws and ordinances goveming this <br /> iype of work willbe completed whefher specified herein or not. The granting of a permit does not presume to give authorify to violate or cancel the provisions of any other state or <br /> locallaw regulaSng construction or the performance of construction. Thaf/am authorized by the ownerof this properlyto perform the work for which application is made and! <br /> comply wrth the State Contractors Law 98.27 RCW aad 296 200 WAC <br /> Ci#y of Everett O�cia!Use Only <br /> FEE <br /> • � � <br /> ���� <br /> PERMIT# <br /> � � 62�o'ZI <br /> 0 er/Authorized nt Signafure Dafe (Revised 10/92/2015) <br />