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�LECC. TR!C L PERMIT A PLIIICCA11O
<br /> .7-**/77.4.„,..----"
<br /> -tgi. -j- CiTY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.govlpermits
<br /> P• e JECT SII114:INFO::ati ,ti 42.k. ,
<br /> PROJECT ADDRESS: t--o5 G/0..\5 ,.,� &e.rc. 'i l.J 0. t lir-dri t IA 3
<br /> BUILDING AREA(if residential,new construction,remodel,or addition) 5 a 0 SF
<br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ,&COMMERCIIAL -
<br /> USE OF BUILDING: 6j�4Loi...Syt.- -
<br /> aECY'R C.1C AkiLi0AltiION pNF®RMAT*QN
<br /> CONTRACT PRICE OF WORK:$ I)OPO.e,
<br /> NUMBER OF DEVICES(if low voltage):,
<br /> FIRE ALARM? 0 YES 0 NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: 6-U,.5 6\-tu,a k .-1.-E> .cc,-i ...3. ( (Pki, w��AA.I
<br /> ems_ po�se� c...0..........fa...-4-7
<br /> - CONTACT INFORMATION :..
<br /> OWNER NAME: 1“4.4 1,J oorfo , TENANT NAME(If Commercial): 14..(4,4-k_ 1..ti•eTlor'L
<br /> OWNER MAILING ADDRESS: STREET j 5'57-q 8-r' .,,r /4 v2.
<br /> CrrY dK.-0�,0‘,.t,yt,ZN, STATE C{ ZIP i taf 6
<br /> OWNER PHONE: 4Z$ 23L ,:%g2(p OWNER EMAIL: J 4DL.o.ww......r-t-ktt .t_. ..a,r`4 „ y
<br /> CONTRACTOR NAME: t-00,,.`, 1 g L t: (...c
<br /> CONTRACTOR ADDRESS: STREET t421 A v . 6 4t5k.co
<br /> CITY 4. �,..,�4 L STATE w ZIP /?T?Togo
<br /> CONTRACTOR PHONE: q2.5 330-1614. CONTRACTOR EMAIL: >�oSeel.•..1�..A.w.4tio�- �5 .‘.....d.“.f.4-11-A
<br /> CONTRACTOR LIC,#(REQUIRED): .14/((,t.(,f,44,r� `Z3 6•( CITY OF EVERETT BUSINESS LIC.#(REQUIRED)4'
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<br /> PRIMARY CONTACT: ❑OWNER XCONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME:' J t$ j-{,A.A.-.n-t-{ CONTACT PHONE: /125 2.3 2.- I 24
<br /> . CONTACT EMAIL: 10 f{`L-C-�t. L.u e �-
<br /> J J-..
<br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct Alt 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 properly to perform the work for which application is made and I
<br /> comply with the State Contractors Law 98.27 RCW and 296.200 WAC
<br /> City of Everett Official Use Only
<br /> FEE -------_ _
<br /> . ' * 12 i 5-1
<br /> PERMIT#
<br /> ix ,Zi -SZ :r h, \B093- 056
<br /> /Au�. rlentSignature Date (Revised 10/12/2015)
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