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��=:-� L��C��I��C��.i� p�U�l�v�l�`� Q� �II�Q`�nCo�G�� <br /> , <br /> �'� -' C1TY OF EVERETT PERNIIT SERVICES <br /> ,.���f u <br /> 3200 C�DAR STREET, EVERETT, WA 98201 <br /> (P)42�-257-8810 � FAX 425-2�7-8857 � (E) everetteps@everetiwa.gov� www.everettwa.govlpermits <br /> ;.. _. _ <br /> _.,.;_ .. . . , <br /> ..: <br /> ; , pG���J�(��i'. �Q�t'�.QI�lI��G�6�631�1�'I��.�I . _ <br /> _ _. _.... . .. <br /> .... .. ... . .. ___ <br /> . ... , .. , .._. <br /> .., . <br /> PROJECT ADDRESS: �j �j U ��(� (.,e,J /✓l'�.�� L- <br /> BUILD]NG AREA(if residential, new consfruciion,remodel, or addition) 7 SF <br /> BUILDiNG TYPE: ❑SFR-0ETACHED �I SFR-ATiACHED ❑ DUPLEX ❑ MULII-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: <br /> .. :.. , -- ,. .... <br /> ,... .. _.. _.. .. ._ <br /> _._ . . <br /> GL�L��u G�OC�l��.�f�PI�OC/.�`�➢�It� Illr�[�OI1�GP9V�`1���1� <br /> CORiTRAC7'PRICE O�WORI�:$ I � �'r'>C7 ��% C� <br /> 1�UIVISER OF DE!/ICES(if low voltage): <br /> F1RE AIARIVI? ❑YE5 IVO <br /> AS50ClA7ED BUILDIiVG PERMtIT#(if applicable): <br /> DESCRIPTION OF UVORFC: <br /> � . ,-t-'i� _C�N i�' <br /> a.t � <br /> _..._ - - <br /> . .. . . : . _ _ <br /> . ,_ <br /> _ . . _ . <br /> _ . - <br /> _ -_ , ..t�Ol��",AC'�`,g��0I8Ni0�1'��06e9 _ - <br /> OWNER MAME: � G� G�- TENANT NAME(If Commercial): <br /> OWNERMAILINGADDRESS: sTaEEr �7 dcz P L- <br /> CIN �,��' ��" - STATE ZIP <br /> OWNER PHONE: OWNER ElV1AlL: <br /> , _, . .. ,. ... . ... , <br /> CONTRACTOR NAME: ' .t i �' ��-l' (. �C. <br /> CON7RACTOR ADDRESS: sTReEr L/ 6 " � � = <br /> --� <br /> a rv ���i. � - � STATE � zi� � .� <br /> CONTRACTOR PHONE: S`" �S _� " I `� � " CONTRACTOR EMAIL: �/'r�c . � ' r i-rT� "' cN �� <br /> CONTRACTOR L[C,#(REQUIRED): � ����.-- 4-- � CITY OF EVERETT BUSINESS LiG#(R�QUIRED): ������ <br /> PRIMARY CONTACT_ ❑OWNER ❑CONTRACTOR ❑OTHER(Pfease Specify) <br /> CONTACT idAN"iE: CONTACT PHOt�E: ZS – 7� � —J � �;� <br /> � CONTACT EMAIL: ' <br /> C �f{L�� � r�% ;,• , ��'i C�C£' `cG'[,`�'c; r C v ' �.G� <br /> AGREEMENT.-T hereby cedify t6at I have read and e ined this applicafion and know the same to be t�ue and correct. Al1 provisions of/aws and ordinances goveming fhis <br /> type of work will be complefed whether specified herein or not. The granting of a permit does nof presume to give authority to violate or cance!the provisions of any other state or <br /> local law regulating consfrucfion or the performance of consfruction. That l am authorized 6y the owner of this property fo perform fhe work for which application is made and! <br /> comply with the State Contrar,fors Law 9FJ27 RCYUand 296 200 WFlC. <br /> Cify of Evereti Offrcial Use Only <br /> FEE <br /> I /� � ���Yn�� <br /> / / // _-_ <br /> / <br /> / / <br /> ! / PERMIT# <br /> ` �'��'' r Z -/ /-/ � 1�1 I�' '�� -- <br /> Owner/Authoriz ' Agent Signature Date (Revised 10/l2/2095) <br /> / <br />