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" __� �L��Gc�I�dC��� p��l�u�i�� �1�l��QC����oOl� <br /> � � <br /> ��y�-� C1TY OF EVERETT PERMIT SERVICES <br /> ''�� 3200 CEDAR STREET, EVERETT, Vl/A 98201 <br /> (P) 425-257-88'10 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits <br /> ,. - . , . - - <br /> _ - -- ,... , <br /> _ , , <br /> , , G°jLR oO�fsC lf ��li L �[�1`Pr�G'�fi'�li L�`�QOO ,I�l <br /> PROJECT ADDRESS: ti/ <br /> BUILDIIVG AREA{if residential,new construction, remodel, or addition) SF <br /> BUILDING TYPE: � SFR-DETACHLD ❑ SFR-ATfACH�Q ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMM�RCIAL <br /> USE OF BUILDING: C � <br /> --- — J -------_- -- - - ---� -- <br /> - — — -_ � <br /> ,..- <br /> ,. . <br /> C�L G��1i G�➢�IaQ L��PI�DC�Ia I���L�1 0(r�l tP�oOG�rl�dL�lI➢Olivl , <br /> � <br /> _ <br /> _ . . - -- <br /> COiVTRACT PRICE OF WOR�C: $ � � <br /> f�lUfV1BER OF DEVICES (ifi low volfage):� <br /> FIRE ALARM? ❑YES l�N� <br /> ASSOC(ATED BUILDI}�G PERiV11T#(if applicable): <br /> DESCFZIPTI�fiI OF 11170R€t: <br /> .... . ._. ; ;. . . _. _ <br /> ,. <br /> ... <br /> : . <br /> . . _ . . _ <br /> '_ ,,: ..��N`d'W��-fl�G���MA'Y9�� :::.. .. - <br /> OWNER NAM�: e� TENANT NAME(If Commerciaf): <br /> OWNER MAILING ADDRESS: srrzEEr <br /> CTTY STATE ZIP gT'J p? � <br /> �WNER PHONE: � � o�a ' "J`v'j OWNER EMAfL: <br /> ,_ . _,. . . .. _. ,. _,_.: ... , . �, . ... ,. .. . . ..... <br /> CONTRACTOR NAME: �(�Q W P*� � 'P�(�+ ' <br /> CONTRACTOR ADDRESS: s7HEEr I O J oZ / ��' ✓ S <br /> cirv !Z/ �l 1 sTn-rE ziP a? � <br /> CONTRACTOR PHONE: � � $s%(Q` CONTRACTOR EMAIL: `Q� �' p� Q ( , rrt <br /> CONTRACTOR LIC.#(REQUIRED): �C �,Q� G G I. F C[TY OF EVERET?BUSINESS LIC.#(REQUIRED): (�H�y O "J�S <br /> PRIfl/IARY COI�lTACT: 1�„OWNER ❑CONTRACTOR C7 OTHER(Please Specify) <br /> CONTACT NAIYIE: CONTACT PHOME: C� —" 3 �'— Q � <br /> ��(�(�ie/LJ `� � `��'���1 CONTAGT EMAIL; <br /> AGREEI✓IENT. T hereby certify that I have read and examined this application and Icnow the szme io be true and correct. All provisions oflaws and ordinances governing this <br /> fype of work will be completed whether specified herein or nof The granting of a permit does not presume to aive aufhority fo violate or cancel the provisions of any other state or <br /> loca!faw regulating construction or the performance of construction. That l am authorized by(he olvnerof this prope�ty to perform fhe work ior which application is made and I <br /> compty with the Sfafe Contracfors Latv 98.27 RCW and 296.20o WAC. <br /> ' Cify of Everett Otficia!Use Only <br /> FEE <br /> , ��� � � � <br /> PERMIT# <br /> a � � W� � �� ( <br /> � <br /> O AufhorizedAgentSignatw�e Date (Revised 90/92/2095) <br />