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. 7,.. „:.:::..: <br /> CITY OF EVERETT PERMIT SERVICES. <br /> 3200 CEDAR STREET, EVERETT, WA 982011 <br /> (P810 J FAX 425-257-8857 J (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> IPIRt 7Lr-"S.�-'U,'1�:,Cy��1 .�11[Y li-®t\F,e.i�[�49®,IIC�J:i•. .. .. : <br /> PROJECT ADDRESS: S0o-5 ...0z / Io,i�/ ✓fi d - f} /,3 <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF <br /> BUILDING TYPE: 1:1 SFR-DETACHED 0 SFR ATTACHED ❑DUPLEX ❑ MULTI-FAMILY #OF UNITS: `COMMERCIAL <br /> USE OF BUILDING: "e-&- // <br /> L PT„lg: ; 1PPLOt ATIO N INF!It':MAT9O!! <br /> CONTRACT PRICE OF WORK:$ s`'�000-'— ' <br /> NUMBER OF DEVICES(if low voltage):. <br /> FIRE ALARM? /AYES CI NO <br /> ASSOCIATED BUILDING` PERMIT#(if applicable): i <br /> DESCRIPTION OF WORK: ..G/J ,1t �,Pcc' ,/ e ft i94-4, � , /e c '. 3 a�G . <br /> - CONTACT R4FORIVMATJ®N. :• <br /> : :.. <br /> OWNER NAME: a - j TENANT NAME(If Commercial): C.b-- J� <br /> OWNER MAILiNG ADDRESS: sTREEr ...TOc7- CAtf-;-,. c2 ,e.o • <br /> cm, Cr-t./er- 7STATE Cc/7/ • ZIP 9fze7-5 <br /> OWNER PHONE: „ . OWNER EMAIL: <br /> CONTRACTOR NAME: / o xi9.c✓ C7 i� OdN__``cc) / -063.--- e r•� "- 6- <br /> CONTRACTOR ADDRESS: STREET/9:CC 6/ ST.?4) ' <br /> CITY , /T-CG- . STATE A104 ZIP , frc) 7 <br /> 'CONTRACTOR PHONE: '760 k•c 8/t, CONTRACTOR EMAIL: ,e%YfC/#'/ i7r1cJ f', e_ - (,�/4-1CONTRACTOR LIC.#(REQUIRED)• /1467X/1 0'F° 1``7 A/LkCITY OF EVERETT BUSINESS LIC.#(REQUIRED): OIVI <br /> PRIMARY CONTACT: El OWNER (CONTRACTOR ❑OTHER(Please Specify) £#O I " I k <br /> CONTACT NAME: CONTACT PHONE: O»& 6 •-?..z-.2,/-0 <br /> i• io-d:Z.c/1 //e->v CONTACT EMAIL: x44 0,Le.e., QO cJ f,`e-- G an, <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 governind 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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE h k <br /> �j PERMIT# <br /> A, /% v. /� I'l \r. a: ,,.../,,,,,„,., koLp_.., <br /> e, - /Authorized sent Signature Date (Revised 90/12/2015) <br /> . 0 <br />