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�LE�T'�I� �, ��R�1�`T —L1�ATI <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98209 <br /> (P}425-257-8810 � FAX 42�-257-8857 � (E)everetteps@everettwa.gov] www.everettwa.gov/permits <br /> ,;=. !" _ ` ' PRAJECT SI'7'E INF. - - :ATiAN <br /> . .. ... . _.. . . .. . . . ._. � _ .. .. ..._ . . , <br /> PROJECT AQDRESS: "S�Z� �C���,,t��, /�1`U�C,. <br /> BUILDING AREA(if residenfial,new construction,remodel,or addition) � SF � <br /> BUILDING TYPE: j�'SFR-DETACHED ❑SFR-ATTACNED ❑ DUPL ❑MU I-FAMlLY-#OF UNITS: - ❑COMMERCIAL <br /> USE OF BUILDING: h 1(�r'1�.'�- . <br /> , , ... ;.; . :. -.- � <br /> _., , <br /> .; <br /> ; EC, RICAL' !'PLICATION INFARMATION <br /> .. .. :. . . .:: . . .. .::, . ... ::. , .., ._.... �.....� <br /> _. _. . .. .. . . _ _ .. . .... <br /> .. . _ .. _... .. <br /> CONTRACT PRICE OF RK:$ 6� � <br /> NUMBER OF DEVICES lfiag .� <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUfLDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �'�'��U�i C�s�.- �`t3J`� G.. YLif(i�I�. <br /> �� -- cas -a� - <br /> �e. �5a$ - D� <br /> , ., .. . . _ <br /> ...,. . .. � ._ . . . . <br /> . _ : , <br /> . <br /> �: CONTACT INFORMATION. ' <br /> OWNER NAME: C:. �� �NV�t"S n fNT S � TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srReEr �{(�Z I I�A�E K j5(.V D S 1� <br /> Cf1Y L/�C �T STATE W/� ZIP ��ZO�I <br /> OWNERPHONE: M�T'� � C�( OWNEREMAIL: /��4'C"C/t'��5�`( C'� G-/"�hIC.. C��'`1 <br /> CONTRACTOR NAME: � .���,f M�"�—'" � � J <br /> - - �"� - <br /> CONTRACTOR ADDRESS: srReEr <br /> cilv -�� (� C� �are 'j'��f� <br /> CONTRACTOR PHONE: CONTRACTOR EMA[L: ' � � <br /> CONTRACTOR LIC.#(REQUIRED): CITY O�EVERETT BUSINESS LIC,#(REQUIRE : <br /> PRIMARY CONTACT:W�f�OWNER .(�CONTRACTOR ❑OTHER(P(ease Specify) <br /> CONTACT NAIVIE: CONTAC7'PHONE: 3 (�(�, �O( . °��S(5� <br /> <M,pt�' �Q��( CONTACT EMAIL; ��T� � (���K �11R 1 l.. C D✓"� <br /> AGREEMENT.�T hereby certify that i have read and examined this applicaSon and know the same to be true and correct AI!provisions of/aws and ordi�ances goveming this <br /> type of work willbe completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cance!the provisions of any otherstate or <br /> loca!law regulating consfruction or the performance of consfruction. That!am authorized by the owner of this property to perform the work for which application is made and I <br /> comply wrth fhe State Contractors Lav✓98.27 RCW and 296 200 WAC <br /> City of Everett Officral Use Only <br /> FEE <br /> � � � �_ <br /> PERMIT# <br /> � Z� ��-, � t� 3-- c c� c� <br /> Own ' d gent Signafure Date (Revised 90/12/2015) <br />