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� .�l-; �L��C��f�QGG'�1L. f�CG��i�li ��1� aG������1 �00�� <br /> ��L�r�(;.� CITY OF EVERETT PERMIT SERVICES <br /> ��� 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everettvva.gov/permits <br /> � PG���JC C�' �Q u C� ��JGa��LQ�i'�OO L�1 <br /> PROJECT ADDRESS: f�e.� � <br /> BUILD]1VG AREA(if residential, new construction, remodel, or ddition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNII-S: COMMERCIAL <br /> USE OF BUILDING: V d(� <br /> _. — . -._— <br /> _ . - .- <br /> , _ GL Tf'C�D��L Gd�G�ft�d0���`�00�1 QR�L�oOIi�G�G�If 0�� <br /> _ _ , _ : <br /> co►vT►�c-t'P�icE o�uvo��.: � , U - � <br /> P�UMBER OF DEVICES(if low voltage): <br /> FlRE ALAF2tVi? ❑YES NO <br /> ASSOCIATED BUILDIi�G PERMiT#(if applicable): <br /> DESCRIPTfONI OF!lVORkt: <br /> d i2, +� k- <br /> •S � <br /> _ _ _ _. ; _ <br /> , <br /> ���`�`�,C'�° �I�9��R9�t��i°���. : <br /> OWNER NAME: �S TENANT NAME(If Commercial): <br /> OWNERMAILfNGADDRESS: srReEr <br /> C�7y STATE ZIP <br /> OWIVER PHOPIE: OWNER EiVIAIL- <br /> _ . _.. . . .. ,.. ,. _:... ,. . _. . -. ,. ... , ,,.:... . . . . . .. . . .. �.. .�., . .. ,.. ... ... <br /> CONTRACTOR NAME: �v�CCJ <br /> CON7RACTOR ADDRESS: sr�eEr � n. ' <br /> CITY v O� STATE ZIP � <br /> CONTRACTOR PHONE: �'" � 1 �- � CONTRACTOR EMAIL• ��-' Z � � <br /> CONTRACTOR LIC.#(REQUIRED): � �p�� GITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> .._.�_.__ . ._.... __„ .�.,� _ __.. .. , , . . <br /> PRIMARY CDNTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAiVIE: CONTACT PHONE: 6(�l 2�' — l Z <br /> CONTACT EMAIL: ��C `� � �,.� � <br /> AGREEMEN7: T hereby certify that I kave read and examined this application and/cnow the same to be frue and correct. All provisions of/aws and ordinances goveming fhis <br /> type of work will be completed wheEher specified herein or not The granting of a permit does not presume to give authority to violate or cancel the provisions of any ofher state or <br /> local law regulating construction or the pertormance of construction. That l am aufhorized by the owner of this property to penorm fhe work for which application is made and! <br /> comply with the State Contractors Law 98.?_7 RCW and 296.200 WAC. <br /> Crfy of Everett Ofr"lcial Use Only <br /> , FEE� <br /> �� °� <br /> . <br /> � PERMIT# <br /> - 3 - 1 � � ��03� ��� <br /> O - ufhorizedA entSignatin�e Date (Revised 90/12/7_095) <br />