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��,����,Q��� ������ .����.Q������ <br /> ClTY OF EVERETT PERMiT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820'1 <br /> (P)425-257-88'10 ( FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everetiwa.govlpermits <br /> . , . . . .,.. . _ - . . - <br /> .. ....... �.... ...:......._.._ :, <br /> , .: .; ... _ . ��3��9��`�:�9`�'� A���6���`�'A�9'�'�:.:: ..�. � ;.,.� �: �. . . <br /> PIZOJECT ADDI2ESS: �� ��/`L-��,,� /J�!/k1i(� ,� - <br /> BUILDIfVG AREA(if residential,new construction, remodel, or addifiion) � SF � <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHEQ ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUlLD1iVG: • � <br /> ..,., :. . .. . :. :.. ::. ....:�::. ..: ..._..... ... _ :. , ,. . . ,:.,_ ...: .:.�,.. . .: . <br /> . .... ,.,:...� . <br /> . . . , <br /> .: . . .. <br /> ��L��"�R�CA�;e�PP�,�CA7"I�PI �N�OR�A'�"iO�d � <br /> COAITRACT PRICE OF WOR}C:$ ���`—' � <br /> NUMBER OF DEVICES(if low voltage):• 6�/P/��� <br /> FIRE ALARNi? ❑YES ❑�10 <br /> ASSOCIATED BUlLDING PERM (if applicable): /1/fi4� � <br /> DESCR(PTIOAI OF VYORK: � r �n.� C-��'f��- l GC�='�-� =� <br /> :,,.... ._.. ....•: .... - . � . . . ......:.. .:�..._. ,.... .�. ... _ - . . . - - - - . .. _ . - <br /> �. .. ..: � . <br /> .;...... . . _ - _ <br /> . ... ....: . . . . . .. .: <br /> � ..:.: -. ,-�: . . ...�. . .:::....:. :;.: -.�:ONTAC'Z° I[a1FORMAi'1A1±1,. :.:: :.. - <br /> OWNER NAME: /✓��COr�l��� �C/�/@� <br /> OWNER MAILING ADDRESS: sraeer D j'L��"f� <br /> CflY � STATE 71P <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: �j�� �'�C�/v J' <br /> CONTRACTORADDRESS: sraeEr �� `Ti%Z �`�- �'�-3I- <br /> CITY �?LC.� C STATE �' ZIP <br /> CONTRACTORPHONE: ��—��U.- j� � CONTRACTOREMAlL: ' ,z;f � <ilt f/1/ /1�( <br /> CONTRACTOR LtC.#{REQUIRED): CITY OF EVEFtETT BUSINESS LIC.#(R U1RE ): <br /> PRIMARY CONTACT:�L]OWNER K �ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: ���� ��.�_ GONTACT PHONE: �Z 5_ '3�� � �!/ � � <br /> CONTACT EMAIL: <br /> AGREEMENT.�T hereby certify that I have read and examined this applicafion and know fhe same to be true and correct. AIl provisions of/aws and ordinances governing this <br /> fype of work will be completed whether specified herein or not. The granfing of a permif does not presume fo give author'dy fo viotate or cance!the provisions of any other state or <br /> local law regulating construction or the performance of construction. That!am author'rced by the owner of this propeity to perform fhe work for which application is made and l <br /> comply with the State Contractors Lav✓18.27 RCIN and 296 200 WqC <br /> City of Everett O�cial Use Only <br /> FEE <br /> . � � �_ <br /> PERMIT# <br /> �' / � � � l �,-< < �- l� � <br /> 1 � � <br /> r/Aufhorized Agent Signafure Date (Revised 90/92/2015) <br />