120 SE EVERETT MALL WAY 2020-02-04

LLECT ICAL PERMIT LA Flikic TinN r_ CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov! www.everettwa.gov/permits . ' • PROJECT SITE INFORMATION": PROJECT ADDRESS: Z o S£ \�� ✓l/ C` IM/LA'LL. wPrl BUILDING AREA(' - 'denti. •-w constructio remodel,or addition) 14-4/ X Z SF BUILDING TYPE:XSFR-DETACHED 0 SFR-ATI-ACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: f TTO(4 4X -_OTRIGAL,A L @TION IIdFORMATION CONTRACT PRICE OF WORK:$ 4 -n (C7 OO 0 NUMBER OF DEVICES(if low volta.-): (P FIRE ALARM? ❑YES U' 0 ASSOCIATED BUILDING PERMIT#(if applicable): )3 I (a ) 0 - 0 12— DESCRIPTION OF WORK: ! OJ S •t_ Z 00 Is` 5e2 t t •7- �� l A- S s2 Vt c.t✓ e c>i (/) 2- ' A/. P 1n 1 .1•J%0 9 A- cStia� Z 2-e- W 1 Vlit r✓ l S i/�C C tom✓- rar4L7to/L Pro Qo) (s) ON CT.INt°ORMATION. : . OWNER NAME: E 124 5 X V i gS0 Oi/t(V(L6CTENANT NAME(If Commercial): U5-T?N.1 C S/A-� 641— OWNER MAILING ADDRESS: STREET 12.0 Vl 'fit — ("444-- � L CnY STATE ZIP (f OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: SGYV YSt••)C2- 6.1( 117/./V--- 1 NL _ CONTRACTOR ADDRESS: STREET ISCa ' '' 0 �� 18 14 `T /F� Q CITY S S' 'oSTATE v" ZIP C,1-0Z 7 CONTRACTOR PHONE:C2&0 7/8—c 9 QL-1 CONTRACTOR EMAIL: ifclwC/v o Hitt CONTRACTOR LIC.#(REQUIRED): c/2036/ 9:g3 D IV CITY OF EVERETT BUSINESS LIC.#(REQUI- D): t75/ 3E-0 PRIMARY CONTACT: ❑OWNER NTRACTOR ❑OTHER(Please Specify) CONTACT NAME: y ,j CONTACT PHONE: C'z Oto) -7/ d--cam 9(D(-47am ( N )c Jt T CONTACT EMAIL: / I j f -J » H-E W i i r& , YU/4u AGREEMENT T hereby certify that I have read and examined this application and know the same to be true and correct All provisions of laws and ordinances governing this 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 l am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 9 0 / PERMIT# -7 Lc--- /) Ee4q - (coo Owner/Authorized Agent Signature Date (Revised 10/12/2015)