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joipo__ . <br /> -- CITY OF EVERETT PERMIT SERVICES <br /> 3200 1 A ' STREET, EVER " , A A 98201 <br /> (P)425-257-8810 I FAX 425-257-885' I (E)everetteps@everettwa.gov .everettwa.gov/permits <br /> PROJECT:SITE INFORMATION <br /> PROJECT ADDRESS: -C i 10 8--V 3►W Ot✓l../ uVA Y <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED ❑SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: cGOMMERCIAL <br /> USE OF BUILDING: Lure) C <br /> ELE6TRICAL A pikicAYION INF61RMATION, <br /> CONTRACT PRICE OF WORK:$ J I Cr."— <br /> NUMBER OF DEVICES(if low voltage):• <br /> FIRE ALARM? )21-YES ID NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): y`1i "O1 6, <br /> G�.Q,G�VI L� <br /> DESCRIPTION OF WORK: �1v 1 lir lrh o'I <br /> PA IA* c-PRA r i1)4 . <br /> .:._..: ..._... . .-may-. _ : :COIaTACT. INFOR,NN <br /> IATIO � _ . ... <br /> OWNER NAME: 77 C.C.[ 1 i L1(J)LL./ .(/1 TENANT NAME(If Co <br /> ('mmercial): j d, .- <br /> OWNER MAILING ADDRESS: STREET 6C,1�1 '' (�( g� � LDXJ <br /> /�/ <br /> CRY 1/0 / L. STATE z,p V z,83 <br /> OWNER PHONE: © `�-jOW-NNEER EMAIL: <br /> CONTRACTOR NAME: W� AAL'S PA(r C� It 1�.. . .. ... .., .. <br /> CONTRACTOR ADDRESS: STREET / S(9-3 d� ��.99��/�� (/ <br /> LAccj ' �ia) W" <br /> my L/A)Ai ✓oc✓ STATE tJ4/� 71P� / <br /> CONTRACTOR PHONE: efts-341 -506) CONTRACTOR� ( EMAIL: l,,Of6 7 tAmeNsrA65-e—CE71U .W 02,AA _ <br /> CONTRACTOR LIC,#(REQUIRED): I IJ it la I.AJA CITY OF EVERETT BUSINESS LIC.#(REQUIRED). <br /> PRIMARY CONTACT: ❑OWNER GeQN-TRACTOR 0 OTHER(Please Specify) OQ22t <br /> CONTACT NAME: CONTACT PHONE: t/ 21S —Sc 4 sJ <br /> CSS <br /> -C29 !N kirt-4i CONTACT EMAIL: <br /> AGREEMENT T hereby certify that 1 have read and examined this application and know the same to be true and correct All provisions of laws and ordinances governing this <br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors taw 18.27 RCIN and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> _‘1 <br /> Ang.6-13> <br /> PERMIT# <br /> 41Ai. <br /> E 11,0/3--M <br /> Owner/Authorized AOj S Date (Revised 10/12/2015) <br />