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- ��:�c���o�a� p�����a� a�����a�no� <br /> � C1TY OF EVERETT PERMIT SERVICES <br /> G7�`'' �T <br /> �__— 3200 CEQAR STREET, EVERETT, WA 98201 <br /> (P)425-257-88'10 � FAX 425-257-8857 � (E) everetteps@evereftwa.gov� www.everettwa.gov/permits <br /> : ,. <br /> , ,.._. : <br /> f�[�B��JL�`ii �Qi(G �G�'II�OL�G�LQ`�'dO�NI . <br /> PROJECT ADDRESS: �) , � �V' � � �� ' Z ' � <br /> BUILDING AREA{if residenfial,new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATI"ACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: OMMERCIAL <br /> us�oF suiL�in��: �'uY��YnF�,��\.�k_ � f��Z�l � �, � <br /> �_, <br /> -- <br /> C�L,I��`�'�O��a�.�I�'PLOC�,`�O�L�9 QG�9[�"�C���1(0�� <br /> COIVTRACT PRICE OF WORpC: $ "',v) <br /> IVUMBER OF DEVICES (ifi low voltage): � <br /> FIRE ALARM? ES ❑iV0 <br /> ASSOCIATED BUILDIRIG PERMIT#(if applicable): <br /> DESCRIPTI�A1 OF 1tVORK: ' q i �� � �' �G LCt <br /> ,, <br /> . . <br /> _ <br /> _ .' G�N�'ACiP INFOi�flflllA'�➢OI�. ;: - <br /> OWNER NAME: 5J TENANT NAME(If Commerciaf): n . ��`j <br /> OWNER MAILING ADDRESS: s-rREEr <br /> CIiY STATE 71P <br /> OWNER PHONE: OWNER EMAIL: <br /> _ . _.. . _ .. ... .. .. .... . .... . , _. . ,. .. . . _.. . <br /> CONTRACTOR NAME: `�I(�Fc.� 11 ,�.�'�I►C�'.J <br /> CONTRACTOR ADDRESS: s-rReEr — � �''� <br /> ciTv �1 STATE A z�P z'.J�J,-� <br /> CONTRACTORPHONE: Z.s, 3L4_ �jI �- j CONTRACTOREMAIL: �C`Y � c�m j4'1 ��CC1Y� <br /> CONTRACTOR L[G#(REQUIRED): S' � �� ; - � CITY OF EVERETT BUSINESS L1C.#(REQUIRED): (�,5.5 �j <br /> PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: %-/�?�� �j �7��� � <br /> � YrCir'1�- (,-1G1�z1t�'S CONTACT EMAIL: � r 1� 1 " J� ; 7, � ,�, �:c.'1/3�� <br /> AGREEMENT.�T here6y certrfy that!have read and examined this application and know fhe same to be true and cor cf. All provisions of/aws and ordinances governing fhis <br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the p�ovisions of any other state or <br /> local law regulatinq construction or the performance of constructron. That l am authorized 6y the owner of this property to perForm the work for which application is made and I <br /> comply with fhe State Contractors Law 98.?7 RCW and 296200 WAC. <br /> Cify of Everett Official Use Only <br /> FEE <br /> A <br /> �.� : '_i <br /> i � <br /> � PERMIT# <br /> i , <br /> ��. ., <br /> �- � � •1`(- 1� � I �� �'(� ' <br /> Own r/Aufhoriz d Agenf Signatur Date (Revised 10/12/?_015) <br />