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LECT QCAL PERMIT A:Hi LLIICAM] <br /> CITY OF EVERETT PERMIT SERVICES <br /> r3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PJECT SIITLE II F®"6lfdATII®IN'',: . <br /> PROJECT ADDRESS: of 13 0 IfYlQv v-1 C er V_ Pgk �J , <br /> BUILDING AREA(if residential,new construction,remodel, or addition) / SF <br /> ,BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: yV COMMERCIAL <br /> USE OF BUILDING: 5 - „I (Zs L-ea55G)'1, <br /> . ELE��'>r��CAL APPUCA`Pd®N >INFQR A`�'0�11� <br /> CONTRACT PRICE OF WORK:$ 00 2 QZ.70 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES ENO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �n g7re�GI )'1}e ?- - PV 10`T4 oti't5,, 40-0k-up <br /> 2 INS 6 vnzte,ef5, 17to <br /> OWNER NAME: --7;1,.--1,e,01-+ TENANT NAME(If Commercial): 6 <br /> OWNER MAILING ADDRESS: STREET / 3b INt A ,r\ L Cs ect Pi2 <br /> CITY STATE ZIP <br /> OWNER PHONE: ( / ` , OWNER EMAIL: <br /> CONTRACTOR NAME: / 'I ..I[4e !�IG7 f% . L Z6, <br /> . . .,.0 <br /> CONTRACTOR ADDRESS: STREET PO ZC'57 <br /> CIN c(4,0(`C, l5 STATE L(,='t.. ZIP 9.7. 15-- <br /> CONTRACTOR <br /> .7. 15CONTRACTOR PHONE: yZ 5 3f6 7 CONTRACTOR EMAIL: Irvlee(ecrlz_ tic_ kO 44( 1' 60/'1 <br /> CONTRACTOR LIC.#(REQUIRED): Ole i vl,e,L,967 ( - CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 413 Ni r. <br /> PRIMARY CONTACT:'4WD OWNER �7 CONTRACTOR 0 OTHER(Please Specify) <br /> _.�._. <br /> • <br /> CONTACT NAME: /� CONTACT PHONE: V75--:-3YY_ 73 2 I <br /> ��A�rio// _._./ of CONTACT EMAIL: r�„(/�I tee(' l�Q r"Z-I([. (-vvu-1 ( , (0 44 <br /> AGREEMENT:T hereby certify that!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 l am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> • O/ <br /> 3 D <br /> PERMIT# <br /> zy- <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />