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�'"�`= r • _-°�, � � e .�,m. ;i P +�, e^ -_ Ps .: � �; tf'�V R � � � '�?a n , u k�,. <br />CIiY OF EVERET'i PERMIT �ERVICE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� �O � � �1�1r�{� i�r ve, <br />PROJECT ADDRESS <br />`� k�� .l ?�O � <br />Owner <br />� �%'r1e- <br />Tenant <br />Mail Address <br />Mail Address <br />�yo <br />City <br />City <br />�c.e�.--�,�, <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />lt�o� /U 6� <br />EleCtfiCal Contractor Maii Address City State/Zip Phone <br />,4 � <br />State License Number (required) <br />e��� � <br />Proposed Use of Building <br />Square Footage (I residential new construction, remodel or addition) <br />II � <br />Number of de ices (If low voltage) <br />City of Everett Business License Number (required) <br />y�a� <br />Contract Price of Work <br />�ex ��5 y�s-3�- g7 71 <br />Contact Person/Contact Number/Email <br />�� ��-, I� ��. / <br />Description of Work to Be Done: �YyI/�, �i�/74 � /�l�� CI rCut "T , ��f2� �� �`a��� <br />l� h L,IJ�?" �) � je l,�P�S 7� Gt���� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certify that I 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 will be completed <br />whefhe� specified herein or nof. 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 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. n \ , <br />ature <br />REVISED 08/06/2014 <br />FEE <br />r �.�-, �1�� <br />PERMIT# <br />E I��a��'1.�� <br />