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1,02R 2S-4;0 2 7 a/56Z (3/42,1 <br /> =LEC RICAL- PEI-MIT <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa-gov 1 www.everettwa.gov/permits <br /> � .. va.,..t+. .. .... .....:....... ..c ... .. ....... ,:rh,,.•w-1vv:.:4'f:.r.a...::Yi < .t;r <br /> PROJECT ADDRESS: H O^v2-j ?ULU `f� r �O!U'�f i 1 ).,.• j .. . :.... _ _ ,.:: <br /> COS <br /> BUILDING AREA(if residential,new construction,remodel,or addlti6n) SF • <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY #OF UNITS: X COMMERCIAL <br /> USE OF BUILDING: r OE./ & EVE rr <br /> 1L: PPII=I ;O <br /> A'7'I <br /> N INFORM:.. �Ql <br /> ATI <br /> N- <br /> CONTRACT PRICE OF WORK:$ (RD P,(DO <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES I NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 'I1 r Im-T- . .\1 ;3 WI- iuo ' E5?StatV <br /> vre_ OLA cute rel • <br /> • <br /> •:, .. ,'r - C011�TACT'I<�[FORMATION: • <br /> OWNER NAME: TENANT NAME(If Commercial): 13C.EpJ6 <br /> OWNER MAILING ADDRESS: s-ren r Pa £0X 3707 d <br /> crry .501.7 7-a - STATE / A ZIPqR2iL 2207 <br /> OWNER PHONE: <br /> .OWNER EMAIL: <br /> CONTRACTOR NAME: ge E til._ <br /> CONTRACTOR ADDRESS: smear Po 36OX 4/ <br /> STATE qg2Z)171 <br /> CONTRACTOR PHONE:426-2/4 4 / T44 CONTRACTOR EMAIL: k4-,e1. H4017/nEjetfl L'Q/Y) • <br /> CONTRACTOR LIC,#(REQUIRED) �I���'C C�8210 Z CITY OF EVERETT BUSINESS LIC,#(REQUIRED):04o5ei ... <br /> PRIMARY CONTACT: 0 OWNER E[CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT7� NAME: CeDW�/ CONTACT PHONE: ZO'-7j O-65447 <br /> . D�/Y 4 If S CeDW CONTACT EMAIL: DEN Ai IS.e KOLil e KIE-WIT, 60M <br /> AGREEMENT:Therebyceriify 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 78.27 RCW and 296.200 INAC <br /> City of Everett Official Use Only <br /> FEE r(J 3 C)._54 <br /> o <br /> • <br /> PERMIT# <br /> 4v, , 1.0 E MOS - c ( <br /> Owner/Au orized Agen Signature Date (Revised 1017212015 <br />