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• nLCCCTRIC AL PERMIT AP r'1LIICCATRON <br /> CITY OF EVERETT PERMIT SERVICES. <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everefteps@everettwa.gov I www.everettwa.govlpermits <br /> ' . ::: PROJECT,SITE INFO•G ATIO .: <br /> PROJECT ADDRESS: \\A ,is\ckk `. Sfi' 6.)-e„4- , lti} (fit 1%. -4tZ <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: ❑COMMERCIAL <br /> USE OF BUILDING: <br /> LE <br /> . . .. LECTRa:6A1>�A�'ts�L9C�/��5�I®6� 11.1�>��+?i �'Y`�11��! <br /> e,: <br /> • <br /> % <br /> CONTRACT PRICE OF WORK:$ 3 9J <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES 0 NO <br /> _ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: fte �� eUz-'\-- ( i�C-u.- e_A-(s4-vi <br /> •(e f` A 5+ — 4 Al 05-.4-3 . <br /> . <br /> OWNER NAME: c, 5 S S TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTRtti <br /> CRY STATE ZIP <br /> OWNER PHONE: ... .OWNERfPEMAIL: <br /> CONTRACTOR NAME: C. ,� n5P r� fes-- -c Cc L <br /> CONTRACTOR ADDRESS: STREET <C1 i 7 CO( L to` <br /> IAA U SA( 4v" CIN STATE 1 A fit ZIP /LJ�' <br /> i'CONTRACTOR PHONE: (1'$r 7 3 % CONTRACTOR EMAIL: %0D1: Std"'_JJJQIeL �e L .. CO <br /> CONTRACTOR LIC.#(REQUIRED)` SS2 1c),3 :. .....CITY OF EVERETT BUSINESS LIC.#(REQUIRED):�iNcec3`1 <br /> PRIMARY CONTACT: El OWNER ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: r CONTACT PHONE: 60'5-- Qc <br /> �� <br /> 2- Z-n <br /> I i` r_-..,, tmc d�• CONTACT EMAIL: <br /> AGRFFMENT.-T herreebyceertify 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 1 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 /> 4 <br /> \ t) <br /> T <br /> 111II <br /> PERMIT# <br /> 1 f- /- (- E ri11 -OD <br /> Owner �ed7gentSi'ture Date (Revised 10/12/2015) <br />