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To: PacJe 3 of 3 �O'1 �1-03-'1 L'1 G:47:5�3 (GMT) '188F3F357�3'1 ��6 Frvrr�: Oavi�1 Wyzatt <br />� <br />� <br />� � �� <br />��'Y� ■ O� � i ����� �� f� ��Y l���Nvu� <br />3200 CEDAF2 STR�ET, EVERETT, WA 982Q1 <br />4��-25i-881 Q- FAX 425-257-8857 — v,rww.everettwa.org <br />'� 1 � 2 � r-aa.ci�„�a. �,�v� �fr ��-, t,J/.� � �S 2c� 2 <br />PROJECT ADDRES5 <br />_ `3�.0�. ����w�.�� �.rP�P��- <br />Own@r Mail Address ^ . Gity ��� <br />W�4-, `� � zo 2 <br />StatelZip Phone <br />�/i 1� � T��d� Cf' ��� i� V1�1� (� <br />Tenant Mail Address Cify State2iN Phone <br />t�.�.,rn.�--�- ��PG�-�r� �.U. ('aax `�-4 ��„�e �.t15 r�� q�z�Z� <br />EleCiri ai Co�itfBctoC Mail Address City Sfate/Zip Phone <br />�.�..`C'_ �C � �i 5 <br />State �icense Number <br />Proposed Use of [3uilding <br />Square Footage (!f residential new cnnstruction, remodel qr addition) <br />Number of devices (If low valtage) <br />��d �� Od <br />Cantract Price of Work <br />Contact Rerson {Plan Revievr) <br />[�escription af Work to Be Done: ��., � � j � ( ; q �„ -�-s k- � �`c� � -�- �9--i .,�.,�L, rF , • <br />v <br />FEE ___ <br />ClTY (5� �VERETT L.QCR�. SALES TA�X COD� IS 3105 �/„��„( ) <br />�{J -/ �� <br />I her�by certify thaP ! have read and examined this appilcation and know the same to be true and <br />correct. All provrs6ons of (aws and ardinances goveming this type of work wril be completed <br />avhether specified herein or not. The gcaniing of a permit does not presume to give aufhority fo PERMIT� <br />vro(�te or cancei the provisions of any other state or local law regulating corrstrtrction or the .^/ <br />performance of cvnsiruction. That !�m authorized 6y the owner of this property to perform tlre E U V�� u�_� O�� <br />worlc for whici� appiication is made and ! comply with the State Cantractors Law 18.27 RCW and � <br />236.200 W�C. <br />ature <br />kEv�sEo a2a��s <br />