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�.� -x CI�CC 11���� �,f� pCG��i��v /�[��LdCI��'Il�� <br /> C(TY OF EVERETT PERMI- _RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 42�-257-8857 ] (E) everetfeps@everetfirva.gov � wwvv.everettwa.gov/permits <br /> , :.. .: ...: ;. <br /> _.. .,. . . _, ; <br /> ,. ,. <br /> . <br /> ; ,:. ,... I����A��`l� ���'� Iil���l�6Fd��`�'6��!��, .� <br /> . ._.. .... . . _ . ._... _ ... . . <br /> .. . __... <br /> PROJECT ADDRESS: '�j�Z�� � , �' , „ .�j�(2.✓ �� <br /> BUILDING AREA(if residen#ial, new consfruction,remodel, or addition) �D � S� <br /> BUILDING TYPE; ❑5FR-DETACHED ❑SFR FlTTACHED ❑ DUPLEX ❑ MULTi-FAMILY-#OF UNITS: CI COMM�RCIAL <br /> USE OP BUILDWG: ' <br /> ,.__. _ . <br /> ; ,: .: .:.; ..-.. .. : <br /> ,.: <br /> IEI����'�d9CA� �i��L���"�9�G�1 ll4'��'���(1�'�9�1� ' <br /> CONTRACT PRIC�OF WORK:$ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIA7ED BL1ILDlNG PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: � � �✓ �� � <br /> CONTACT�INFORMATION� - . � <br /> . . ... ,. , ._ . ; . . . . _ . <br /> � <br /> OWNER NAME: S���: � .P/ {-�,i ��NANT NAME(If Commercial): <br /> OWNERMA]LINGADDRESS: s�eEr I" 1��� �v <br /> (� /� / <br /> CITY :'� STA7E �.}'� ZJP l� <br /> - � <br /> OWNER PHONE: OWNER EMA1L: . <br /> CONTRACT�R NAME: 'W � f <br /> CONTRACTOR ADpRESS: srRe� <br /> ' CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(RECZUIRED): CITY OF EVERETT BUSINESS tIC.#{REc1UIRED): <br /> PRIMARY CONTACT: L7 OWNER ❑CONTRACTOR L7 OTHER(Please Specify) <br /> C�NTACT NAME: CONTACT PHOt�t�; <br /> GONTACT EMAIL: <br /> AGREEMENT.'T hereby cerfify that 1 have read and examined this applicafion and know the same fo be true and correct AlI provisions of laws and ordinances goveming this <br /> fype of work wi!!be completed whether speciited herein ornot The granfing of a permit does nof presume fo give authorify to violate or cancel the provisions of any oiher state or <br /> /ocal/aw regulating consfruction or ths performance of construction. Thaf l am aufhorized by fhe owner of this property to perform the work t'or wfric%application is made and l <br /> cornply with the Srate Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everetf Offcial Use On/y <br /> FEE <br /> C L� <br /> , <br /> � � �� , � <br /> � PERMIT# <br /> -' - <br /> � �( <br /> _ . � o � � <br /> ; . <br /> ; � � � <br /> _ 1 <br /> Owne �zed A Signa�ufe Da e (Revised 10/92/2095) <br /> � <br />