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,. <br />, <br />! <br />,�- __�_ � ���� .����_____� <br />E�.�GTR.IGAL PERIVI�T APP'LICA7IC�N <br />CITY t�F E'VERET� F'EF��IIIT SERVI��� <br />� � 3200 C��JAR STRE�T, EV�RETT, V1/A 98201 � � <br />425-257-8810 '- �AX' 425-257-8$5� — www.ever�#twa:e�rg <br />�� � � AP'PLiCATIONS ARE ACC�PTER FROM 8 AM 7t) A PM <br />� ,��� <br />���_� v� . <br />F'ROJECT AR�7RESS <br />4 ����-�' �j -� t1 �'i� E'c� I o� 2�`(� 1 � �� . �" ���-�.,�"� v�1iy-- �i �z�� <br />Owner Maii Address City State/Zip Phone <br />W..d.._ , <br />� �� Tenarii � � �� MaU�Address � L.itY: �� StatelZip Phone ; <br />�.�� Y11G� ` �� � C � �� � �5a � � ����'f . �� ������� ��__ ����� <br />� <br />.1eCtriC�l Cnrlfractor ' Mail Acidress City 5fatel�ip Ahar�v <br />��?�� �3� �5��� <br />��.. c- � � <br />5fate License Number Caniract F'rice of Work' <br />�tJ iv� �i G� � �"�t � �C�C��7/% Gi/ �-� t � S-�'+-�` <br />Proposed Use of Buildmg r� �C'(/� � Contact Person {F�lan Review) <br />� �- (``'' ,�_� ��%� ��,i �1.. (�� %' <br />< < � r� C-�- �„�.� __ _ <br />Description of Wflrk to ge Done: <br />NU1`�: WII�lNG IN 1��7N-DVt��LL�NGS IS R�C;�UIR�(� "fC) ' ' F�� ' <br />BE IN RACEWAYS, MC OR AC CABLE . ,,,. <br />� �� Cu <br />CITY OF EVERETT I..00AL SAL�S' TAX COC3E iS 3145 <br />1 her�l�y ce�trfy #!?s?t 1 have reac! and ex3mined tliis applic�tion ��nd know tt�e sarr7e ta t�e true and ' <br />cdrrecf. All provrsroi 'a"� �ws �racl ardinances gcrvemin� tliis typ� ot worit wrlt be conapl�tecJ �i � ,( � <br />whetf�er speci�ed 1�rQin rto(. Ti�Q granting of a;nermr� tloss not prest��rre to �iva'audl�o�it� ta � L� ��.�i l/ �� �i "i � s <br />violate or cance! ti e prav�ions of any ofher state or (oca( !aw regu(atir+g constri�ctior� or the � <br />perfntmance of c nsfructi n. That 1 arn authorrzecl by fhe ow��er of tl�is prope�iy to perfonn the 1_________ .__. ___ ___- ---- <br />wnrk (c+r w�icir I' 'or is m e�nd ! c�mply with tt7e St��te Cor�trr7ctor's L�w �8.27 RCW and <br />29G.2�10 W : .. , � <br />/� ' ,;% �--' <br />.�- � ,�,� ,� �-�,� �� �. <br />/.. r r .. . � . . . ... . . . . <br />11aIlYf2 � �-'ittt; <br />