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��.c���.a��� ��r����r��������� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@evereftwa.gov� wvvw.everetfwa.gov/permits <br /> . .. :. _ . .. .,.. .. .,r_.,._. . . : _:>. .. ......:...: . _ <br /> .: __:. . ..._.....:_.._. ..... <br /> . � � , � .: .� :. � � �R�J��`� ��`�� �6���R�1,s�'TO�N:�.': .. . ... . <br /> PROJEGT ADDRESS: SOD S� ¢- � <br /> BilILDING AF2EA(if residential,new construc#ion, remodel,or a dition) � SF ' <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OP BUILDfhIG: O� "ttSL r¢ i • . <br /> , , :.. . .. . ....... ... ......_::.,.; ... -:.:�.,.. ., .. ... .. :., : ,:..: . ..:..:.�..,.., ..: _.. ,. .;,.,. : .: . ... <br /> . . �.. .. � . ,..,, . <br /> :. <br /> _.. .. <br /> _ . :. .. � E� '. .ICAI�APP�tiCA°TION ��1�09��t1A7"tON._ :: ..._..:..:.:. .:.:.: .........:..:._•..._ <br /> COIdTRAGT PRICE OF WORK:$ (oo,°O � <br /> IdUMBER OF DEVICES(ifi low volt ge);• <br /> FIRE ALARM? YES O C� L, , <br /> ASSOCIATED BUILDIIVG PERM[T#(if applicable): v��rv�.�, <br /> DESCRIPT[ON OF VVORFC: �c�c� dv �r.7C o�,�{'-�+� ��,-k�o�ta� v ��v2 a,�av�w� � <br /> ex� a,' �w� . <br /> ..:..: �. _.. . . . _ _ _ . _. . . .. . <br /> _,...:... _. . .. .. : � . . _ . _ , <br /> . . .......: :;.. ..- .... .. ..,.... .. : .: . ... ... d ...:. . . _ .. . .. .; <br /> :. <br /> . -::. .:.:'-. .,.; ..,� ..CONTACT 9NFf1RMAT10N. :.._: : <br /> OWNER NAME: tZo�OW�,sah �vro TENANT NAME(If Commercial}: p.�..�� <br /> OWNER MAILING ADDRESS: s�teEr SOO S�. (F WIcL��U�b1- � ZO S <br /> C1TY �/ll�'Y'�L� STATE G�I ZIP �4�(J <br /> OWNER PHONE: �{�, • 0 OWNER EMAIL: �' <br /> CON7RACTO:R NAME: � <br /> CONTRACTORADDRESS: srFteEr �?j 00 C7e (n,2,QQ. � � <br /> crn M t l� �'ree srare W zip B O <br /> CONTRACTORPHONE: 'fjS'- 3� - � 0 CONTRACTOREMA[L: 5pf}RK t? �-•Cp ' <br /> CONTRACTOR LIC,#(REQUIRED): �41nEL�G���I�c.�� CITY O�EVERETT BUSINESS LIC.#(REQUIRE :(�S � <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR LCI OTHER�(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (- ZS��S�1- �R OZ <br /> /!/l t K� �,uoa D� <br /> . CON7'ACT EMAIL: �S PafL�C �l L.G6 <br /> AGREEMENT.-T hereby cedify that!have read and examined this application and know the same to be true and correct. All provisions oflaws and ordinances governing this <br /> type of work wilt be completed whether specified herei�or not. The granting of a permit does not presume fo give authority tq violate or cancel the provisionsof any other state or <br /> /ocallawregulaSng construction or the performance of construction. That i am alithor'rced by the ownerof this property to perform fhe work tor which application is made and! <br /> comply with the Stafe Contracfors Laiv 78.27 RCW and 296 200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> �� `i' <br /> PERMIT# <br /> ��-��«.�l�tJ�w� �" �' �8 � 1�l r� �\. <br /> Owner/AuthorizedAgentSignature Date (Revised 90/92/2095) <br />