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[jLECT ICAL PERMIT fI ;1r UC N ION <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 a@everettvva.gov j www_everettwa_govlpermits <br /> :�: � : �• IPIR�a1IE[��••�.I�T1�.��l;i'=0,4�1�Qi`i'.1��+1'�•�' <br /> _ <br /> PROJECT ADDRESS: d 2_1, L w <br /> . BUILDING AREA(if residential, new construction,ernodel,or addition) SF • <br /> BUILDING TYPE: TASFRDETACHED In SFR-ATTACHED LI DUPLEX 11 MULTI-FAMILY-#OF UNITS; LI COMMERCIAL <br /> USE OF BUILDING <ud— ._. <br /> . ._LE�'Tit ��L�AF'1��.��'a�"�'��fe1.INf�fSRi1f1A'T�l�il�!•. <br /> CONTRACT PRICE OF WORK:$ f" Le). <br /> NUMBER OF DEVICES(if low voltage);•; <br /> FIRE ALARM? IA YES O. _ASSOCIATED BUILDING PERMIT#(it applicable): <br /> DESCRIPTION OF WORK: l � <br /> •. "•'` <br /> CONTACT I10O01411[O0• • <br /> ' •�:�. <br /> OWNER NAME: �j� y TENANT NAME If Commercial : /414 <br /> OWNER MAILING ADDRESS: sTRssr fed 24 ` 2-4 --- - -- <br /> CITY eVC12eir STATE Le <br /> OWNER PHONE: ' S—'S — eS'13 _ OWNER EMAIL: • <br /> CONTRACTOR NAME: e•••- <br /> CONTRACTOR ADDRESS: STREET �b <br /> CITY A. jaw STATE ZIP . d <br /> CONTRACTOR PHONE: g S SC/I CONTRACTOR EMAIL: j '/le", <br /> CONTRACTOR LIC_ • REQUIRED)! U E-2-4:1P. 5— CITY OF EVERETT BUSINESS LIG,#(REQUIRED):-=)51442:1 <br /> PRIMARY CONTACT: %.74 •WNER LI CONTRACTOR ID OTHER(Please Specify) <br /> CONTACT NAME: <br /> '���//�� CONTACT PHONE: „all., <br /> /'�?���CJC'�S ��,.�-�b� CONTACT EMAIL: <br /> AGREEMENT:Thereby certify that 1 Neve reed and examined this application and know the same to be true end correct All provisions of laws and ordinances governing this <br /> type of work will be completed whetherspecitled 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 taw regulating construction or the performance of coonstrvctIon. That!sm authorized by the owner of this properly to perform the work for which application is made and 1 <br /> comply with the State Cantrectors Law 18.27 RCWand 205.200 WAC. <br /> City of Everett Official Lisa Only <br /> FEE <br /> • <br /> 4— o i <br /> PERMIT# <br /> E 66(0- <br /> OwnerJAutfiorized Age t Signature Date (Revised 10112/2015) <br />