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,--�._ <br /> ._, , ��CC�`��aC�Q� p���u�i Q� ��i�i��C� � ���00� <br /> �� � CITY OF EVERETT PERMIT SERVIC�S <br /> ��� 3200 CEDAR STREET, EVERETT, 1/1�A 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � ww�n�.everettwa.gov(permits <br /> , <br /> PI��dLC�`i� �iQ�'L �V�I�r�G�6�1�`�'DOfi�l ..- , - <br /> PROJECT ADDRESS: �p O S'� G -f—N�a tl <br /> BUILDING AREA(if residenfial, new construction, remodel, or addiiion) SF `� <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPL�X ❑ MULTI-FAMILY-#OF UNITS: �,COMMERCIAL <br /> USE OF BUILDING: �,2*�-p,,v` <br /> _- . _ _ <br /> C�L��C��['G'�O��aL c`��1�1�OC��Zl51'��h� OR9�'�L����'f Q�G� <br /> CONTR.4CT PRICE OF VIIOR�:$ 2^I�J�� <br /> R(UMBER OF DEVICES(ifi low voltage);� <br /> FIRE ALARM? ❑YES YVO <br /> ASSOCIATED BUILDIi�G PERMIT#(if applicable): � <br /> DESCRIPTIOf�I OF VVORaC: �Vt„�, r �w� �j �a�..�- C���i�`�aS�� <br /> _. _ <br /> _ <br /> , ` . C�N7'AC�° 9RIF'�OFtIV1A'lflOt�l : ,:. . <br /> OWNER NAME: W (>r.i�.e, Pro er-('�PiJ TENANT NAME(If Comrnercial): (l2cc{G+ �(j�Coo��� '�7� .�J <br /> OWNER MAILING ADDRESS: sraEEr CO R�{7 �pQ ��(L ���O q <br /> ��n �/'e�,J��y�-c� STATE ��- Z�P Ba s q <br /> OWNER PHONE: w (p-2 -s(o� OWNER EMAIL: /� <br /> CONTRACTOR NAME: ��y�; �� <br /> CONTRACTOR ADDRESS: srREEr (7j p O o'��L �F 0 <br /> cin M�dl Cree(C STn,z �-- ZiP R�o l2 <br /> CONTRACTOR PHONE: L{�- ZjS - l`�o�- COIVTRACTOR EMAIL: /Li 5P1k2 �('j LJ FFO�--'Ga PV� <br /> CONTRACTOR LIC.#(RE(�UIRED): C(lQ�(�G"�O (�pc.I� CITY OF EVERETT BUSWESS LIC.#(REQUIRED):O�j r'J� <br /> .._.�:.._ .. __....�:-..,_,_ _.._,:.�. ..,...,._.. ._-....�... . ... . :..: . .�. .,._. .,- ...:_ ,.:_..: . ,.,,.... _ . . �.__.,_ ,�. _._. �- - - <br /> ,. _. . .._ .... <br /> PRfMARY CONTACT: ❑OWNER �ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Gf�s- �jS�- (QU Z. <br /> � r°LI� CONTAGTEMAIL: MSP14R� �L7@I�t6L��� <br /> AGREEMENT.'T hereby certi(y that l have read and examined ihis application and knov✓the sarne to be true and correcf All provisions of/av✓s and ordinances governing this <br /> type of work will be completed whether specified herein or nof The g�anting of a permit does nof presume to give authority fo violate or cancel the provrsions of any other state o� <br /> local law regulating consfruction or the performance of construction. Thaf!am authorized 6y the ownerof this property to perform fhe work for which application is made and l <br /> comply with the Stafe Contracfors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> �0 . �- S <br /> PERMIT# <br /> � ��a� 3 -s-�8 � �$63 - o2Z <br /> Owner/Aufhorized Agent Signature Date (Revised 10/12/2095) <br />