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I nit,:AL t'ttiMI I Rr It,iM I I'VNY <br /> Oftg77 911F11,; CITY OF EVERETT PERMIT SER CES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 j(E)everetteps(everettwa.gov j www.everettw .gov/permits <br /> foltaiRCr SITE INFORMATION <br /> PROJECT ADDRESS: 1 OI a-1 C v erg veer W a./ , v,er Os. <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 12 3-7►Z SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: figI COMMERCIAL <br /> USE OF BUILDING: rykoVaIp Gaon ` v,c2 <br /> EI T*II 'i .ApPmATios 11000101SATION,; <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES X10 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: S <br /> L v <br /> —XAS ��tVl LA/MU Gk''Calf Uvk rYciv `�r Cf' <br /> N '�` <br /> oo Si„+ P \V\ � G�c ti V� cite/ �'t:(C(CC, C� tPGvti'T <br /> CONTACT INFORMATION <br /> OWNER NAME: .0-i re CAA\( TENANT NAME(If Commercial): e3oost <br /> OWNER MAILING ADDRESS: STREET t 0 I a t v C-C 5 ref,a l./•3 0-9 <br /> crrY Vex k1 STATE WV). ZIP • <br /> OWNER PHONE: a(*- - t1 12WNER EMAIL: <br /> CONTRACTOR NAME: 'TA dC P h t 1 c% r�i/l { M\. 6t oh p�� <br /> CONTRACTOR ADDRESS: STREET CI 3 tot )W I'3-`'X11, <br /> art ?coc\ kart STATE O(l, ZIP 4/ - tq <br /> CONTRACTOR PHONE: 9(p- O t- %41,A (CONTRACTOR EMAIL: ' ' (�c-�S'ICQ�(1R 5 is u� 3 '� G 0 yri <br /> CONTRACTOR LIC.#(REQUIRED): Ph t , to ()Ar e Q .4 CITY OF EVERETT BUSINESS LIC.#(REQUI D): ����'"ll <br /> PRIMARY CONTACT: D OWNER %CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 5 03 - .01- %l,.f i <br /> CONTACT EMAIL: -fid tr(4s tool <br /> AGREEMENT.!hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of taws and ordinances governing this type <br /> 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 h am authorized by the owner of this pmperty to perform the work for which application fs made and I <br /> comply with the State Contractors Law 18.27 RCW and 296200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> .I/M'i1. <br /> A.e.)-(t) 11111% <br /> Awner/Alithnri7ael Anant Ainnetnre rate /RnviroriQ/9a/91NRl <br />