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;�=-� ��c�c��rr��oc�a� p���v�o� Qu���Q� � �flo� <br /> �,/��,� �� CITY OF EVERETT PERMIT SERVICES <br /> �/�L� 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-88'10 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits <br /> , .. <br /> ,.-_- ,:. <br /> , ; Ga'Li���JGC�'� �01('C� OG�G�OGG���11'�O� _ <br /> : _. <br /> PROJECT ADDRESS: � ,e�r� Lti{� u? <br /> BUILDING AREA(if residential,new construction, remodel, or addition) SF � <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHFD ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: �COMMERCIAL <br /> USE OF BUILDING: <br /> _ — _ _:. <br /> G�.C��i'6�D�L�a�. �IPPLOCc��1���� DI��OL'�il�l�a�'0�6�1 <br /> COR�TRACT PRICE OF WORpC: $ Z <br /> tVUMBER OF DEVICES(ifi low voltage). <br /> FIRE ALARM? ❑YES I�RIO <br /> ASSOCIATED BU1LDIi�G PERMIT#(if applicable): <br /> DESCRIPTIOIV OF IfVORK: {� �� 3 C <br /> . ,. . <br /> CORI�',AC'�` ➢r1FORNiA'TIOt� ` <br /> OWNER NAME: TENANT IdAME(If Commercial): r^( � <br /> OWNER MAILING ADDRESS: srrzeEr <br /> C�7�y STATE 71P <br /> OWNER PHONE: OWNER EMAIL: <br /> •- -. . . .. _. ,. _:.... _. _ ,. .. . . ... . <br /> ,. . . . .. . _ . ._. . . <br /> CONTRACTOR NAME: � ZE�, d�1J'(Z�3 <br /> CONTRACTOR ADDRESS: srREEr � (`� � �'` � e G� <br /> �,n �'r � STATE Z�P L <br /> CONTRACTOR PHONE: Ti — c�yL—�Z CONTRACTOR EMAIL: 'G� +�� L'C � IC� II <br /> i <br /> CONTR.4CTOR LIG#(REQUIRED): (, �S�( D�'� CITY OF EVERETT BUSINESS LIC.#(REQUI D • <br /> .. .�,._,,,_ . .__.., r_. ,.,.,_ _ _.. :.,:._ : ....,_.,. ... ,....,.. _ _.:.., ..,.__,_.... . ..........: . ...--,:�.� .,.,,......, _. . ... .:. .-:......,.. _ _._,.-:..._. ... -_.._, .v._..: ,........ ... <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> �' i <br /> CONTACT NAME: CONTACT PHONE: f�ZJG _�Y6- 73a � <br /> � CONTACT EMAIL: <br /> AGREEMENT.-T hereby certify that 1 have read and examined this applicatinn and know the same to be true and correct AlI provisions oflaws and ordinances goveming this <br /> fype of work will be completed whether specifed herein or nof The granting of a permit does not presume to give authorriy to violate or cancel ihe provisions of any otherstate or <br /> local law regulating consfruction or the performance of const�uction. That l am authorized by ihe ov✓ner of this property to perform fhe work for which application is made and 1 <br /> comply v✓ith the State Contracfors Law 98.27 RCW and 296.200 WAC. <br /> Cify of Everett Offrcial Use Only <br /> FEE <br /> �� � �Z -0 �-� <br /> PERMIT�# <br /> �/�-/ � i� 0�1' �`��' <br /> r/Auf orizec genESigna re Date (Revised 10/12/2015) <br />