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-������a��� ����a� ���c��-��o� <br /> CITY OF EVERE7T PERMIT SERVICES <br /> 3200 CEDAR STR�ET, EVERETT,WA 9820'I <br /> (P)425-257-88'10 { FAX 425-257-88�7 � (E) everetteps a�?everettwa.gov� www.everettv✓a.govlpermits <br /> .::. ... .. „. . _,.. . ... , . . - .�. ........: . __ . .. <br /> .:...,. �.._.._. : ..,�. .. . : .. .. : . ,.. , <br /> , . . . �R����`��p�'l��������i�`i'I�Pe�::. ��.:. '" . �:.. _ <br /> PROJECT ADDRESS: " /P Z i —� � <br /> BUfLDING AREA{if residential,new consfruction,remodel,or addition) � SF ' <br /> BUILDING TYPE: ❑SFR DETACHED ❑SFR-ATTACNED ❑ DUPLEX CI MULTf-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BU1LDfNG: (^j'�/V� � <br /> : . . ..�.-� . :: :. ......�:. � <br /> ,. ....; ..r : <br /> : .:. . <br /> �,. ' . �L�l��`9'B�.I�AL a4PP�d�d�,`�ION �9V�'�R8�8d4`d°�OQd , .. . <br /> CONTRA.CT PRICE OF WORK:$ ' <br /> tdUMBER OF DEVICES(ifi low v Itage):� <br /> FIRE ALARM? ❑YES <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTI�N OF WORK: GG�V �..�-���' ��/ ,�tit Q j�J <br /> �:":�c..:..... ....... .... . . . . .. _....;.. � . .. . . - . .- _ . .. . <br /> ,_. . . <br /> �... . .:.... .. .:.... . : .: <br /> . ... .... _.:..:._ . . _ .. - .. : <br /> ... . . ...: .:',-., :,..:�:: CONTACT-INFORMATIOfd. -- : - <br /> OWNER NAME: �G�(:7 %N��S TENANT NAME(tf Commercial): <br /> OWNER MAILING ADDRESS: sraeer fi C�vc% '�✓✓ <br /> � C17Y jvL7�( STATE yV � � ZIP � � <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRAC70:R NAN(E: (� �-Tll�'���E '"�Cr.� �/r!bv /'�L <br /> CONTRACTOR ADDRESS: srneer �71G S�3 d�� ��7� Ci <br /> CI7Y /�// t-T SC �L�E STATE �� ZIP �p <br /> CONTRACTORPHONE:�-�3~' S� �" 33 CONTRACTOREMAIL: G�!'/' �+f,cfTlrl-+�'�GSGGr�✓� /1 50 i'1�(. <br /> CONTRACTOR L[G#{REQUIRED): L7rNI S S��j h-v CITY OP EVERETT BUSWESS LIC.#(REQUPRED <br /> PRIMARY CONTACT:��OWNER M ❑CONTRACTOR vCl OTHER(Pfease Speciiy)� <br /> CONTACT NAME: CONTACT PHONE: Z��j — �C� ��-3 3 7�3 <br /> �" Yr' /v p�f^J CONTAC7"EMAIL; GIYY C�. Gr�SdL'(�-Y� �S�Lt/I , l/YYt <br /> AGREEMEIUT.� hereby certify that I have read and examined this application and know the same to be true and correct. AU provisions oflaws and ordinances governing this <br /> fype of work will be completed whether specified herein or nof. The granting of a permi�does not presume fo give authority to violate or cancel fhe provisions of any other state or <br /> loca!law regulaSng construction or the performance of construction. Thaf l am authorized by the owner of this properfy to perform the work for which application is made and I <br /> comply with the Stafe Contractors Law 18.27 RCW aad 296.200 WAC. <br /> City of Everett OfficiaJ Use Only <br /> FEE <br /> . �O �_ <br /> PERMIT# <br /> a <br /> �, � � ��< < —c�� � <br /> OwnerJAufho z Sig e Date (Revised 90/12/2095) <br />