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m <br /> ,��,���'�.I�A� ����A`�' A����,�`�9�� <br /> • � • CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVER�TT, WA 98209 <br /> (P)�425-257-88�0 � FAX425 257-8857 ) (E) everetteps@everettwa.gov j www.everettwa.gavlpermits <br /> � ,.. .,.. . - - - • - <br /> ::::.:,. _..;: ...,.. ...:.:.:�.: ... . .. ,..: .r . . _.:. - � - <br /> PRAJEG7;,S17'� IAIF�RiV1,ATIAN <br /> ...., � z. . ..::.,,_ � . ,, ... <br /> PFtOJEGT ADDRESS: �p O � GlJ � �O <br /> BiJILDING AREA(if residential,new construction,remodel,or addition) SF ' <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> U5E OF BUILDtNCti: ��-ndY, e�p..�,� • <br /> � - ELEGTRiCAL�,APPLIC,ATION 1�eiF6RMAT10N,��;'.�. <br /> w;:�,. . .: _ : ° -� �� � = - <br /> . <br /> . , •.�::...:.,s.:.,..�:...r:,,,-_.w:.v�.v <br /> . .. ..i. � ��.:..�.:�.:..... . . ..'...:�: e•..h_F"d� <br /> . .:v,.....'��.�J..r:.rc.: ....t•;i .. <br /> ..: . �.: ..�.;, <br /> :.<:�_. . _�.. y.....4. �.._ . ..•..�...:.�:��..r::�.�-. ......._ '..,_. �� _, <br /> CONTRACT PRICE OF WORK:$ �pO i "� ' <br /> NUMBER OF DEVICES(if fow voltage):� <br /> F1R�ALARM? ❑YES � <br /> ASSOCIATED BUILRING PERMIT#(if applicable): <br /> DESCRIPT[ON OF WORK: �-' S�"'«-�I (Ze-�-p�tv� tn,..,� (� (c� o ecc(G/�c�! <br /> �dCI - <br /> ::..::..: ..:.. .:.: . . . . - _ . - - . . .. . .. . ._.. , _ _ <br /> ... ..,:. ..�_:.. :. <br /> .:.:..... - ..� - � _ - - <br /> . .- -. . ... ..... .... . . ... .. ._.. ... �.... ... .. . .. . <br /> _:.. .. :- = . ._:.-. -�:� ..::,::.:�. �.::�.,:C.OI�TACT:INFORiVIATION.:;::.: ._ : _ ` <br /> • - f <br /> .....i.�-.. .�._ . � ... <br /> OWNER NAME- ( 0 ( ) � - <br /> 7ENANT NAME If Commercial: <br /> QWNER MAILING ADDRESS: srR�r (p01 (�..l-F f'� In� S.��P� <br /> CI1Y � STATE G✓ ZIP�(J �d(� <br /> OWNER PNONE: -Z��C- Z2�� ��p�J� OWNER EMAIL: �'-- <br /> CON7'RACTOR NAME: �FNI � <br /> CONTRACTOR ADDRESS: s�eEr � 2j (�p �, C D <br /> CITY I�L C STATE W� ZIP qV O I <br /> CONTRACTOR PHONE: �� - CQNTRACTOR EMA(L: ivl SPf�K ("7 U L �CU M <br /> CONTRACTOR L[C.#(REQUIRED):t�Wl ..J CITY OF EVERE'FT BUSINESS LIC.#(REQUtRED): Q��fS�'I 3 <br /> PR.IMARY CONTACT: ❑OWNER �`�CONTRACTOR���QTHER(Piease Specify)W� <br /> CONTACT NAM�: GONTACT PHONE: L.,'Ztj - 3sy_�q a2 ' <br /> ° OU�/C� t�t(A7� CONTACT EMAIL: /yS�R�� l ��I � A�li• CO <br /> AGREEMENT T hereby certify that l have read and examined this application and know the same to be true and orrect A!I provisions of/aws and ordinances goveming fhis <br /> type of work will be complefed whether specified herein or not. The grantfng of a permif does nof presume to give authorify to vio/afe or cancel the provisions of any other stafe or <br /> Iocallatv regulaSng construetion or the peiformance of construction. That I am aufhorized by fhe owner of this property to perform the tvork for which application is made and 1 <br /> comply v�ith ihe Sfate Contractors Lav✓Y8.27 RCW and 296 200 WAG <br /> Cify of Evereit O�cial Use Only <br /> FEE <br /> �..J � ' SO <br /> PERMIT# . <br /> v"liti �_ VVWW/ ��7�I� � `•-� '..� �, O <br /> Owner/AufhorizedAgentSignature Date (Revised 90/92/2015) <br />