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'_ _� <br />� � �i _ <br />� E�ECTR1��4� ������R�11�` �4P�L.���TI�� ������ <br />CIT'Y t�F E1lERETT PERM17 SERVI��S <br />3�oa c��,� s-r����r, �vE�-�, inr� s$2oa <br />425-257�88�p - FAX425-25�7-8��7—www.�vereftwa.arg <br />� t_� - - - - - � - <br />..,%�1 °� �� � ���`�'1. _-5�:__.��._id�..��� � `'� �" � � �""� �1 �1��! v�.�" `� ����`'`' .�J <br />PROJECT ADDRE55 '� <br />�:�.� t �� U�Ir� C /��"f� �l"7`�. <br />Qwner hRall Addreas Giry SiabetZfp Phona <br />_��__---. _� ' � -- <br />Teltant Ma(I Address ' CIty State2ig Phone <br />�z5- 7'�- $ t f.� <br />-�-�v � i �. ��.�,. �'T"" � r1� � � � � <br />Eleattical'Qnntractor ' Mail Addrasa City ; StatefLfp Ph�sue <br />�"'kll��O�$' Nk� c�2.6 2� �' <br />Stste l.Icense Numkser (req�iredj ; CCty of Everett Bu�(ness �.[cense Numher (requlred} <br />�CQ%�"�.i �R�� ��t�b�-�- � 32� .� <br />Propo�ed Use of Bulldin. g G�ontract Prtce af WorFr <br />N�C�4A�I W,Ai:ti� �ZS-218• l7t��} <br />Squar� Footage,(It residentiai neW cons ctlon, remodel or add{ fon) Cvntact PersonlContact NumbedEmal) � <br />1''j I'i <br />�Number o devlcss if low voltage) <br />� <br />Descrfpiion of Work lo Be Dane� �!"`v V '�` t���� � s,�..r_. ,�I��a [-��CT� �..... <br />FEE <br />� CITY OF EVER�T7' L(7CAL SALES TAX GODE IS 3105 �`�� '��,, <br />L <br />1 hereby certliy thaf f have read and axarnined thls'�PPlfca6on and knowfh� sa�te to be lrue an�t <br />corr�ct AU provlstons of taws and ordinanees gc�t�eming thts type, of work w1A be corraplefad - <br />;t,vhetherspedPied her�sln �rnot The granting ofa pe�rnff rtoes no#pfasome tci �Ive aufhority fo ,,�' pERMZj'# <br />vioJate or cencel the provlstons oi any o#her sfat� orlocel !�w regu(efing construct}an ar (he ���,,.„� �� �,�s J <br />p�rfortnanca of consfrucftan. Th�f t ani auFhorized by the owner Qt th�s property to perform tfrv Y� �`"'� <br />Wor1s for whlCh �pp(lcadon ls made and ! comply with the State Canfraafors La�V �t8.27 RCW �rrd _ <br />286; 2Q0 WAC. <br />� ��''��� �� . <br />��,�,,�,�.~" ' �. <br />_...__. <br />__�_'..T._...� <br />� _ �_..e....._..�5 gnature � �1at�' _ � <br />� <br />��rsev uaqa�ota <br />_.. __. .. _T__. ._ <br />_��_ ��__.__. _ __._____ __..m__ ____�. __,_ _ .._._ _�...��� _. ...._-___ _ _______.._ _.,., �J,�� <br />