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• � <br />�L�� 1 I���✓�� ��IZ��� ��1� �����I � <br />CfTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� �� �� <br />� � /�'!������j��� ,��</C <br />PROJECT ADDRESS <br />�l/�ti�C� � �e'� %�r��X . ��v�� <br />Ownef Mail Address <br />Tenant <br />Mail Address <br />'' � ,� ��= :���%/ � /' <br />� <br />Contractor Mail Address <br />c?_ -� <br />l ���C>_5 <br />City <br />City <br />t���l�� -��� i� <br />c���, <br />��tY <br />���i''C C� � � %7 � > /`�? - — <br />S#ate License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />� �— ��f`�� 5 C <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�f�5 - `���5 �-S� /� <br />StatelZip Phone <br />State/Zip <br />c `� �' ` <br />o r:rU��� <br />State/Zip <br />Phone <br />-�f�P' <br />Phone <br />o��-���. <br />City of Everett Business License Number (required) <br />� � �-- ., <br />S��>C �, <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />l hereby certify that l have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work wil( be completed <br />whether specifred herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am aufhorized by the owner of this property to perform fhe <br />work for which application is made and I comply with the Siate Contractors Law 18.27 RCW and <br />296.200 WAC. � <br />/''�� % � �� ���'�—_ /l; � u? / � <br />REVISED 08/06/2019 <br />� <br />FEE <br />� �j �'� <br />PERMIT# <br />E1�11-eo� <br />