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LECT QC AL PERMIT A lICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> EJECT SATE ANFO' <br /> PROJECT ADDRESS: 3 7e'O red t,\,1 f� 1 e f� 1-' ? 7Oi <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> !BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: AI COMMERCIAL <br /> USE OF BUILDING: r/j. , pi 1y <br /> ELEC°rgitA.L AP LUGAT9ON ANF (RAAATAON <br /> CONTRACT PRICE OF WORK:$ t 'P560 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES CIO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): j <br /> DESCRIPTION OF WORK: Perg,►� / 1 4&\ 4V1301 t Ar ai tj/.c. • <br /> OWNER NAME: V(A # &i,c.` S c_i1W/S TENANT NAME(If Commercial)X._�,A;C zsO(�. <br /> OWNER MAILING ADDRESS: STREET 7,00 (Si-Dad v / <br /> � <br /> errs( VV1 C STATE CAM-' ZIP qO w 1 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: �%.jl L��etc,. <br /> CONTRACTOR ADDRESS: STREET 1/00 Mer-rd/ CYPcA.. �Glr- <br /> CITY g/O.r STATE P1,49ZIP,C te r <br /> CONTRACTOR PHONE: y 2 j- 1f 07- Grj 2 CONTRACTOR EMAIL: t,p-Th L Vv Ie,? b-k , <br /> CONTRACTOR LIC.#(REQUIRED): Vg-ti /Nr� CITY OF EVERETT BUSINESS LIC.#(REQUIRED): OZ -S38 <br /> PRIMARY CONTACT: ❑OWNER V.FONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: )) CONTACT PHONE: 20(2. 1s>r'L Flt if • <br /> S� �}- QT�'�/'l CONTACT EMAIL: Cj -Fj ?r 42_ itt- ica evy;_, <br /> 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 <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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> . . <br /> PERMIT# <br /> Wfbk E 1g0g - oo 3 <br /> !Authorized Agent Signature Date (Revised 10/12/2015) <br />