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ELECT-'CAL PCR,''aT AP LUCAT N <br /> CITY OF EVERETT PERMIT=—/ICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 wwvv.everettwa.gov/permits <br /> PROJECT SITE 1NF0RMAT8ON <br /> PROJECT ADDRESS: 29/( S r., S ( r E e7' Scz r f_ 203 etre-e 71-44. 7 t2O/ <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 356° SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: EI COMMERCIAL <br /> USE OF BUILDING: ot ti c� c�.cT ..1;,•✓q c' `Ka JO <br /> 01:100114I04APPLICATION IINFQRMATION <br /> CONTRACT PRICE OF WORK:$ /21 500 . <br /> NUMBER OF DEVICES(if low voltage):�� <br /> FIRE ALARM? 0 YES IRI NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: G,� ,d ( ‘e_ C f S,77,1 LOa rte-60 uSe _CrCC'_ -E7 r /- e f'ec/`Ca-( <br /> . CONTACT:INFORNIATION <br /> OWNER NAME: f j-d`e.rs j eje (rot(Q`e-r"{ TENANT NAME(If Commercial): &S4 4ta,qu io 84�S LLC <br /> OWNER MAILING ADDRESS: STREET /35'0/ ,.`n--R/ SD N �/ Q�l p <br /> crry � -- <br /> aK'e !e S c/-4.el r STATE Vv Ay zip /Was S 'J <br /> OWNER PHONE: Li 2✓j --sog Oa St�,..�a. ... OWNER EMAIL:. 6(45'4 1'Ca'.�{�te.hGt4 S~�6/rice /, cost y...... .x� <br /> CONTRACTOR NAME: Ai e, r-f L I et A c /e c 'r C i- <br /> -7-it C-.-- J <br /> CONTRACTOR ADDRESS: STREET ��4-3 /e(- to <br /> o�3" e .s may"(� <br /> f� CITY Z__a_<'€ ✓[ --C/a-1% STATE ci J1. ZIP ( d`41(7"--- <br /> CONTRACTOR <br /> S g <br /> CONTRACTOR PHONE: 'T -S 3 77"-f 5/ � p�CONTRACTOR EMAIL: L_7 l'% OA- .G CO COP-lea-CT /l('� ^� <br /> CONTRACTOR LIC.#(REQUIRED):lUo&-rNEz2 18-7/ � wK u CITY OF EVERETT BUSINESS LIC.µ#(REQUIRED)0 5 <br /> PRIMARY CONTACT: ❑OWNER 121—CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: / / CONTACT PHONE: f 2 S 3 q'3 ,..l e?a 6 <br /> C (t ,tT /7 Cr-, ;d CONTACT EMAIL: Cif it1 ( a- ©r'l�'(.�`$7 /VJ '� <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 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 /> PERMIT# <br /> 7___. j1/4e___/9c° , g--( $-/6 E \100% — VS <br /> Os alAutiiorized Agent Sig lure Date (Revised 10/12/2015) <br />