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� i���C��L' �GaL� pL ���ir�Q�( ���Jl',��QG L� ���00�� <br /> ��� <br /> �,f-„���- CI"TY OF EVERETT PERMIT SERVICES <br /> �ur�c��r`�ir <br /> � 37_00 CEDAR STREET, EVERETT, WA 9820� <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � vwNN.everettwa.gov/permits <br /> _ ,, . <br /> ,, <br /> __ . <br /> Pil�O�J�C u� �S�itC D�II��GF2G?.�L�u DOo I�I. . <br /> PROJECT ADDRESS: �� v �t L �: • <br /> BUILDIh1G AREA(if residenfial, new construction, remodei, or addiiion) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED `�'SFR-ATIACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNII�S: ❑ COMMERCIAL <br /> USE OF BUILDING: �� S, CI t,�.��/� � _ __ <br /> _ . �. <br /> _ <br /> - �I���°i�I�O��a Ld�G�pL��C��i�O+i� QI�!'iC�flOG��i�dl�`1���U�� <br /> . . ._ _. .. . <br /> _ _ <br /> CONTMZACT PRICE OF 1JllOR1+: $ - c.. v� /�,-•C� �- -- Z�L� <br /> �IUIVIBER OF DEVICE�(ifi low volfage): <br /> FIRE ALARiI(1? ❑YES ❑ NO <br /> �.SSOCIATED BUILDI�IG PERMIT# 'f applicable): <br /> DESGRfPTtORI OF 11VORFC: ,1 r ,/' t� r � /�S ( � cr� G�` c� �r.i c� �>^ <br /> 't r �/ D c-tJc:/' c�� +` <br /> � Gi c: � C?' �.1 �'O � C' , G� <br /> �\ � �� <br /> , <br /> , _ . : - <br /> , _ _ ', �O�d"6°:4C u �l���iSY4��°�'��Gd <br /> ,. - _. . <br /> OWNER NAME: � �✓' /�� � ' TENAi4T NAtV1E(If Commerciaf): <br /> OWNER IVIAILIIVG ADDRESS: s�EEr �j : �' Cj�r--�� <br /> CIN (f STATE ZIP rJG� � � <br /> OWNER PHOIVE: LI Z S� (J--�'�C� OWPIER EMAIL: ��v � . '� <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: sTReer <br /> CITY STATE ZIP <br /> CO[VTRACTOR PHONE: CON?RACTQR EMAIL: <br /> CONTRAC70R LIC.#(REQUIRED}: CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY COIVTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT IUAME: CONTACT PHOI�IE: <br /> , CONTACT EMAIL: <br /> AGREEMENT.�T hereby certify that l have read and examined this application and know the same to be true and correct. All p�ovisions oflav✓s and ordinances goveming this <br /> type of work wrll be completed whether specified he�ein or nof The granting of a permif does not presume fo give authority to violate or cancel the provisions of any other state or <br /> loca!law regulating construction orthe performance of construction. Thaf!am aufhorized by the ownerof this property to perform the work for wl�ich application is made and 1 <br /> canply wifh the State Confracfors Lav✓98.27 RCtNand 29620o WFlC. <br /> City ofEverett Official Use Only <br /> r-�� - <br /> �� �_ <br /> P�RMIT# <br /> �G'' �— cf J��C i= t,� � �� � - �,�0 cj <br /> Owner/AufhorizeciAgen4Signature Date (Revised 10/12/2095) <br />