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• <br />EL�GiR�C�►L ���IVfli A��LiC�4ilOIV <br />C�TY OF �V�RETT P��M�T SERV�GES <br />32�0 CEDAR STREET, EVERETT, W�A 9820.1 <br />42�-257�8810 . � �AX �125�257�8857 — www.everettwa,org <br />��I.� <br />_�_ --� � '`� �� S� <br />PROJECT ADDRESS <br />rn�� �--� � 3� �3 r1.� � � tv� C�R �' 8 �� �-�s �3�d -s 3� � <br />OwfteT Mail Address City 5tate/Zip Phone <br />�f� <br />Tenant <br />Mail Addrass <br />Ctry <br />State/Zlp <br />Phone <br />I�LJI G�r..��S.r'LL �d(�ev_. { �d� `�c7'�'L *C��r �� �Yd'L� ��`-T��1�� l� ,�j <br />b r <br />Efectrlcal Contractor Mail Address Clty SfafelZip Phone <br />��,E�bP� 8� �� <br />5tat0 l.ice�se N�smber (requif�d} <br />�� <br />Proposed Use of E3uilding <br />Square FQofafle (If resfdentlal r�ew consfruction, femode] or a <br />�luml�er oP devices (If iow voltage) <br />City of �verett Business Llcense Numf�er (required) <br />�.�-'C�'�, , <br />Contract Price of VVork <br />�� <br />Contact ('ersan/Confacf Nurnber/Email <br />Descri�tion of Work to So Dona: L��`�—�-� � ��►-� �� ���� <br />CITY OF EVEFZETT LOCAL SAL�S 7AX CODE !S 3105 <br />! f�eraby certify that ! have read and eY,amined this appl;catran snd know the sAme to be true and <br />correct. All provisions of laws and ord;nances �oveminy thls fype of vrork will be completed <br />vvhotherspecifJed he�in orrrot, The granting of a permit does nof presume to �ivo authority fo <br />viol�te orcancel the provlslons of al�y other state or local la�v reyulatinq constructron or the <br />porformaRce of canstrucflon_ That I am Ac�thorized by ths owner of this property ta perfom7 the <br />ivor�c fo� whJch sppllcatlon Is mede and ! canply v✓ith the State Contr�ctors Lativ 98,27 RCW and <br />296.200 WAC. <br />(� ' Z� —1 � <br />REVfSED OE/OGf2014 <br />w.�.�. , <br />FEE � <br />�> �� i <br />� <br />PERMTT# I <br />� <br />� ( �� � - �'� "� � <br />� <br />