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������ac��� ����a� a���L.�a������ <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR�ET, EVERETT, WA 98209 <br /> (P)425-257-889 0 � FAX 425-257-8857 � (E) everefteps@everefitwa.gov� www.everettwa.govlpermits <br /> .. .. ., ,.. . . . . .. ..; ..... . __ . ... _.. :.«.,::_.. ._., � . <br /> .; . . <br /> . .. <br /> . . .... ., . .. ........ ...... � . <br /> � <br /> , . . �9�.�����i'•:��'��:��I�"��6��`�'fl��d:�`` . : . _:. ,._:.:',. - <br /> �_.:.. . . . _.. . . .: . . .... . . . . ...... :.. . . : .... ... .. . . <br /> PRQJEG'f ADDRESS: .. .. � . 'p S � �V�tr R-��� Y�'l A-l� �tJ ��/ <br /> BU(LDIiV�AREA(if residential,new construction,remodel,or addition) SF ' <br /> BUILDIIVG TYPE: ❑SFR-DETACHED ❑SFR-ATTACt-IED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: �COMMERCIAL <br /> USE OF BIIILDING: �� s y1/(, • <br /> ...;-, . .. .,. .. ... ;. - <br /> . .. .... .. .. ,,..-....:. .�:: .. ._,--•-- : .:.. . . <br /> . : <br /> � : ��.��'1"R���9��,���9�A"�A�� 9$d�'��61fl�`�'0�la9.: . ..:_::.. :. <br /> CONTRACT PRICE OF WOR�:$ /,��p � <br /> pdUIUiBER OF DEVICE�(ifi low voltage):� <br /> FIRE ALARM? ❑YES ❑fd0 <br /> ASSOCIATED BUILDIIdG PER1U(IT#(if applicable): <br /> DESCRIPTIORI OF�f/OR�C: RV N ��' �Y� � f5 p� ' �t. �2 'L � �( �1�k� <br /> . ..... .... .... . . . - - . _. . , <br /> _,, . .. <br /> . ..., :,-.: ; ,,,:. '�� AC <br /> .. .. . . . ... ......_ . . _ . .... . <br /> . .. ... :. _6V°�' ... 'T:INF,O�tY1PllN�T101V.-;.. . - <br /> OWNER NAME: � ��1/`Q- 1e��4 '�TENANT NAME(If Commercial): <br /> ONlNER MAILING ADDRESS: s-raeE-r I�--I�,3 '�.V S �t�-�•� <br /> CRY �V`Q-1`� STATE � � ZIP ���O v � <br /> OWNER PHONE: OWNER EMA[L: <br /> CONTRACTORNAME: �Ay4V�-Q.. (N "�'.�. <br /> CONTRACTOR ADDRESS: sraeer /��3 3 �12v S � Y� � <br /> cilv V��� ` srnre (�J � ziP !"��d' <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: ' <br /> CONTRACTOR LIC.#(REQUIRED): V �S g7b S GITY OF EVERETT BUSIiVESS LIC.#(REQUIRED): �5 2 3�� <br /> PR[MARY CONTACT:� C]OWNER N ,0 CONTRAGTOR ❑OTHER(Please Specify) <br /> CONTACT P�AME: GONTACT PHOME: <br /> = CONTAGT EIUtA1L: <br /> AGREEN/ENT.•T hereby certify thaf l have read and examfied this application and know the same to be true and correct. A!1 provisions oflaws and ordinances goveming fhis <br /> fype of work wi!!be completed whether specified herein or not. The granting of a permit does not presume to give authorify to violate or cancel the provisions of any otherstate or <br /> (oca!law regulafing construcfion or the performance of consfr�ction. That l am authorized by the owner of this proparty to perform the work for which application is made and I <br /> comply with the State Contracfors Law 98.27 RCINarzd 296.20o WAC <br /> City of Everett Officia/Use Only <br /> , FEE <br /> �� v.�./ <br /> PERMIT# <br /> - ` 3 l � �03'D��' <br /> i Y ,� l <br /> Owner/Authorized Agent Signature Date (Revised 90/92/2095) <br />