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ILL CCTR CAL PERMIT T LQCATIIO CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-88110 J FAX 425-257-8857 (E) everetteps@everettwa.gov I www.everettwa.govlpermits Mit 6614g1 PROJECT ADDRESS: 1112,0 ( eM01, PEve eak ` IJ BUILDING AREA(if residential,new construction,remodel, or addition) SF BUILDING TYPE: I ,SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTi. ILY-#OF UNITS: 0 CO v'v RCIAL ,USE OF BUILDING: L► F 4 111=1 �1R8 .d a P[€LcAti 1109 1'7:.. . CONTRACT PRICE OF WORK:$ .S w . NUMBER OF DEVICES(if low voltage): FIRE ALARM? D YES NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: ht.U3 e,\ethr:CC\ Ce—w�'CQ c - ' e. r wo *- *0 b 'ah a..\noose. . Mew de v 'ices to nevi •. ..... • . ..CONi'AG'i`:l<NF®RMATIoN-..-_._ OWNER NAME: 'm k c e i \fah\ TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREEr tk p j 14 2 1irstk , -^ 1n Q�Q 42:27 CITY L r o© STATE W rt ZIP• Ci p()S"I OWNER PHONE:(M25 -- 9.4A. OWNER EMAIL: VWCIr�,L,el ac1/4,),N1 ?! Q . • CO 04 CONTRACTOR NAME: eriti CONTRACTOR ADDRESS: STREET"Cs • CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR Ii.OTHER(Please Specify) -^ - CONTACT NAME: CONTACT PHONE: Lys)... ti Z(p _ y 33 �\.. CONTACT EMAIL: ��-e.Q ChY iSar iY‘C.1/4Svbs.1.-6,rA4 c cb -4A©r AGREEMENT T hereby cerMi that!have read and examined this application and know the same to be true and correct I provisions of laws and ordinances governing this, OSW1 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 local law regulating construction or the performance of construction. That I am authorized by the owner of this properly to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 296.206 WAC. City of Everett Official Use Only 'FEE • 3 ' PERMIT# f E �� 2 - .`� �, �I 1212 - � Owner/Authorized Agent Sig at Date (Revised 10/12/2015)