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joiliv- <br /> LL CT RIC L PERMIT AOKICATION <br /> .► ',iiiigj.;- 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.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: S40 ..Z.5/€ 5A V5 reit T-P.! 'CC/C/ X"f/'L'0 7 : t/ t/✓O <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: 2 COMMERCIAL <br /> USE OF BUILDING: tehjed- pn / <br /> E CTR CAL APPLICATION INFORMATION . <br /> CONTRACT PRICE OF WORK:$ I: S-00 <br /> NUMBER OF DEVICES(if low volta•;-):, <br /> FIRE ALARM? 0 YES peNO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: gepPhee K/577. 2Oee4 1.T,.€7G/ (/Z�zai0 <br /> WI "pea) - -Tiler b,i/ 9'/s go At-44, %o/985 <br /> 4-011) /Awe/ 4ei;e7/ h _575' iiitoof,ffe Jed, gee41/04.-71-5. 4LailiC:=2_41Ze.... <br /> . CONTACT INFORMATION <br /> e _ <br /> OWNER NAME: /)fufri/ r O A5C,40o/SIS I TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 92' 97®0�/4/'4.J ,P!'i'i/C' <br /> CITY< /C STATE uol ZIP 9G� ay <br /> OWNER PHONE: 4,2C-7- 34 -4274/ OWNER EMAIL: <br /> / <br /> CONTRACTOR NAME: ...dosi n 4er C"Oe. d19'C.d a90117.4 e' f� <br /> CONTRACTOR ADDRESS: STREET A 60,,/�/--/Z 4 �/ J� //j y/» <br /> CITY �0�,�I Jif. 6t Th 4 2_ /STATE Alet ZIP ,O 27� <br /> CONTRACTOR PHONE: ,3t 0-� 112/-7O f 7 CONTRACTOR�/ EMAIL: it ez 4 gD �jov�,ere N•G�VV�'7 <br /> CONTRACTOR LIC.#(REQUIRED): 740 X'V66� ?0/ L 7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): S4-.3 2-P <br /> PRIMARY CONTACT: 0 OWNE <br /> R6NTRACTOR 0 OTHER(Please Specify) <br /> ( <br /> CONTACT ME: ® CONTACT PHONE: 34p_.Q.. "Vo 87/0 <br /> LY 'n ter 34D- p10— (D <br /> CONTACT EMAIL: f3�G L 4 �`i'vl ..--e .e 0,'77 <br /> AGREEMENT:T hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions oflaws 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! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 1(Ai-4 - 5 0 <br /> PERMIT# <br /> .5- aroma E t%0S t93 <br /> Ow /Authorized nature Date (Revised 90/92/2095) <br />