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��,�j_;-� I�L��c�'�Ga30C�Q� G�G��v���( ���i���C�/�71�0�� <br /> � <br /> ���J��rC�� CITY OF EVERETT PERI�JIIT SERVICES <br /> `�_% 3200 CEDAR STREET, EVER�TT, WA 9820� <br /> (P)425-257-889 0 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� vwvw.everettwa.govlpermits <br /> I _ . . <br /> _ G�it80�A�C`l� ���� OG�G��G'�fiP�il��i�UOI�I _ _ <br /> PROJECT ADDRESS: �� ;� , �ti,� ` � <br /> BUILD]NG AREA(if residential, new construction, remodel, or addition) SF � <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-Al-I�CHED ❑ DUPLEX MULTI-FAMILY-#OF UNITS:_ ❑COMMERCIAL <br /> USE OF BUILDING: � r f K,,,,�'� ,�'� _ ____ _ <br /> - �� —_ — - <br /> .- -. <br /> _ <br /> GL��G`�'I��C��L �G�f�[����u 0 00�1 QI�G��G`�Gi�dL�1`�Q�G'� <br /> CONTI�AGT P#210E OF WORr.:$ — ' ^ ��-`- <br /> RIUMBER OF DE1/ICE�(if low voltage): <br /> FIRE ALARIVi? ❑YES - NO <br /> ASSOCIATED BUILDIi�G PERMIT#(if applicable): <br /> I]ESCRIPTIOR� OF lIVOR�C: �e L-- O /�-f'c.-'�/�c! "��:^� I �`i� L�--r_ <br /> L -� � c !l � � s �� l/ z �.�' 1 �1 ��� �' L....-�.��'— - <br /> , . .. ,. _. . <br /> _ <br /> _. <br /> _ , <br /> ��Qd`�'d�.C`�'.a1�9��RY�1��flOR�_ : _ . <br /> �--, <br /> OWNER NAiVIE: , � / � S �c� G� TENANT NAME(If Commerciat): <br /> OWNER N1AILihlG ADDRESS: s-raeEr <br /> p�7y STATE ZIP � <br /> OWNER PHONE: L� Z 1 L/� `(�f C•� OWNER EiVIAIL: <br /> CONTRACTOR NAME: �� e r�� �c-( c���-<-c_ i_ �L Gi�G•/ <br /> COIVTRACTORADDRESS: s-rRee-r � s� 'Z z t� �� � ' � �/-r <br /> CITY �G� � G�l J� i � ` STATE �`- // ZIP ��,�`� -� <br /> CONTRACTOR PHONE: f �L L � •-lo�o CONTRACTQR EMAIL: �'�;�' �" C�i:�-.k� '�-Icf J•c�c_�/�i� �,., c_, � <br /> CONTRACTOR LIC.#(REQUIRED):�G4�J� " � � �(G>� !.�J CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> ,._..._�_. ,,..._ ,.. _ _ ...... ..,..,._ .. . . . ,,,... _... _ ..,,�.._ . .. .. . .. , <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAfV1E: �� �/�� / CONTACT PHOIVE: c �Z��—���/`—/C/��'3 <br /> i�M /\i�� �O Cf JT ( �/� <br /> � �/ CONTACT EMAIL: <br /> AGREENENT.�T here6y certi(y that/have read and examined this application and know the same to be frue and correct. All provisions oflaws and ordinances governing fhis <br /> type of work wil!be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> loca!law regulating construction orfhe performance of consfruction. Thaf I am authorized by the owner of this properfy to perform the wor,4 for which applrcation is made and 1 <br /> comply with the Stafe Confracfors Law 98.27 RCW and 296.20o WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> � <br /> , <br /> � U ' <br /> . , G ___ <br /> �.... <br /> "_ .� 4, <br /> � / - <br /> �'�� PERMIT# <br /> . f <br /> `'��- G _ Z7 � i� � �� �� ���� <br /> Qwner/Authorized Agent Signature Date (Revised 90/12/2015) <br /> /: <br />