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�[�C��`��OC��� �Cf��vli Q`� �f�����Q�Q0�1 <br /> C1TY 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.everettwa.gov/permits <br /> ������� �a�� a�s��������� _ , <br /> PROJECT ADDRESS: - ��G✓ �C��j ��iz✓� ��i',�. �✓�-'�-�/ � ' <br /> BUILDiNG AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATrACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: � �5���j���/ /�,�"' <br /> _. ��,ECT'ROC��./A��H�OCA�O�� �I+9�'01�6�i�17�90I�9 <br /> CONTRACT PRICE OF WORFC: $ �,� �(Jc% <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �'�J'�'j ���C'�/����� -�f_-t%�-� /�%'/�� �/� <br /> �},�/,�s Ol�.7'G <br /> CONTACT INFORMATION. . ` <br /> OWNER NAME: �,7`�i`/l TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTaEEr �S <.��L`- /� Q �,����''�"' <br /> ��7y STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME,. _:.... , _. . _ . . ,_ . . . .. <br /> . _.. _ . „ <br /> C,�� • �- � �(,`�1'r� �� �. <br /> CONTRACTOR ADDRESS: sTRE� �/.� (i� v�''- G• �i <br /> CITY �7��/�C/,� L�(�/: STATE � � • ZIP �G/�U'� <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> (/� � i �+ <br /> CONTRACTOR LIC.#(REQUIRED): (7i����=L�� b �v�V J CITY OF EVERETT BUSINESS LIC.#(REQUIRED): �� / <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: �� �- ` � ��5 <br /> ��P,G1� L ��� CONTACT EMAIL: <br /> AGREEMENT.'T hereby certify thaf/have read and examined this application and know the same to be true and correcf. All provisions oflaws and ordinances governing this <br /> type of work will be completed whefher specified herein or nof. The granting of a permit does not presume to give authority to vrolate or cance!the provisions of any other state or <br /> local law regulating construction or the pertormance of consiruction. That l am aufhorized 6y the owner of this property to perform the work for which application is made and 1 <br /> comply with the Sfafe Confractors Law 1t3.27 RCW and 29G.?0o WAC. <br /> Cify of Everett Offfcial Use On/y <br /> FEE <br /> ; <br /> , <br /> � I�a, <br /> PERMIT# <br /> ,� '' - � �--1 �� _ <br /> ,� �'� �� ���- �-�.. � I�'l <br /> OwnerlAuthori c ent ' at te (Revised 90/92/2095) <br />