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�I��CiRI�A�, P�RMIT' APPLIC�4ilON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa,gov � www.everetiwa.gov/permits <br />AGREEMENT: T hereby certily that I have read and examined this applrcation and know the same to be true and conecf. All provisions of laws and ordinances governing this <br />typa ol work will be completed whether specified herein o� not. The granting o( a permi does not presume fo give authority fo violate or cance/ the p�ovisrons oi any other state or <br />local law regulating construction or the perlormance ol const�uction. That I am authorized by the owner o/ this property to perform the work (or which applicaiion rs made and I <br />comply wifh the State Contrectors Law 18.27 RCW and 296.200 WAC. <br />� <br />.� �3 �c� I � <br />nerlAuthorized Agent Signature Date <br />Cify of Everett Official Use Only <br />FEE <br />� �) �✓ <br />PERMIT # <br />E f �l� —(1�� � <br />(Revised 10/12/2015) <br />