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hLECT 1CAL PER TA LiCAT O <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) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> . pit 4i4 GTSITE INF,o .mATI®N`:.... . <br /> PROJECT ADDRESS: c9 , eD f'd ri me 1/". Rai <br /> BUILDING.AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX Cl MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 1`kS� 4r� I1 <br /> CONTRACT PRICE OF WORK:$ /`C' O 0Z, ,s vv <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: /l c.�y rl t,/r V/1‘..)-- 4t-t 14 (7 1�V.C._..,k t')-- <br /> -.,_ -"- .c kir C _. - -- <br /> TINF®RMATI®IV- <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CRY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: GC-L-\,[ Sc.,) . .. ., 4 c v <br /> CONTRACTOR ADDRESS: STREET T.--... ) , X Lia-( <br /> CIN ,(/'y'( 4.e4-21 STATE '-"' 1 ZIP 9s a <br /> CONTRACTOR PHONE: - /?g^-2738 7g CONTRACTOR EMAIL: ' <br /> CONTRACTOR LIC„#(REQUIRED): -- — rr YT+_ymm4„ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):93":" ..'"? <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: c CONTACT PHONE: 21 `� .� -V-Y3 Cj <br /> C�►\,,.c.L r CONTACT EMAIL: ` i . dee Oc` In €c tt r c lit driop <br /> AGREEMENT:T hereby certify that!have read and examined this application and know the same to be rue 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/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 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> rFEE <br /> r <br /> - <br /> Ap. <br /> PERMIT# <br /> 1111 , <br /> ,. <br /> -•�lfrr . _)-r)- /- <br /> ) iiia J0„ <br /> Owner'• ieT. e. <br /> gr re Dae (Revised 10/12/2015) <br />