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L! 'TIC P ERI 0 ,APS SCA- SOH <br /> `�.eC <br /> d„ 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@everetiwa.gov I www.everettwa.gov/permits <br /> : ... ... ...::.. . . <br /> :.,:= P OJ CT:;SITE INFORMATION' <br /> PROJECT ADDRESS: r,? PO ►I ' &T‘ tt/ ,f 11 ' wk . g(6 :a <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF all <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED CI DUPLEX 0 MULTI-FAMILY-#OF UNITS: ,yGOMM -CIAL <br /> USE OF BUILDING: Al J <br /> , : . LECTRICA11,.;:.A�PPII41„CATION INFORINATI® <br /> CONTRACT PRICE OF WORK: 1 C600 <br /> NUMBER OF DEVICES(if low oltage): <br /> FIRE ALARM? 0 YES 0 t <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: MfL1i2„) r1 <br /> t` a t! V A I1 I f • El& Or b NIP, . ILL. C-_. <br /> 114i V U tU1 itt'(" To (qGpot"'f1oM, <br /> CONTACT INFORMA`T'ION .• <br /> OWNER NAME: W/���y -& U_ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1 <br /> IPA-ST <br /> ryy' <br /> C� `'' i 1 STATE WA.'" ZIP/ oilo <br /> ' "EVIG V.W54 OWNER EMAIL: <br /> OWNER PHONE: EMAIL: <br /> ft— <br /> CONTRACTOR NAME: 1 r ' iAitilF 0,J111 t) <br /> CONTRACTOR ADDRESS: sTRE _J c7` 3 14t. pi_ <br /> CITY ^eirrSTATE 14/A-- ZIP ��-=4 r <br /> 33 J40. (OICONTRACTOR EMAIL:SO <br /> CONTRACTOR PHONE. Ste- l AV <br /> CONTRACTOR LIC.#(REQUIRED):��i._PliA')C'9 L .t -LP CITY OF EVERETT BUSINESS LIC.#(RE.AIRED)O 14 <br /> PRIMARY CONTACT: ❑OWNER NTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> e , . can— 33'1-3r��1� <br /> J u t/t t% /`'"i S D I\-1 CONTACT EMAIL: Aviv),II y)lvi S;5' v\` WWI <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. .411 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 I 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 /> 2- . cD <br /> ` PERMIT# <br />