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� <br />� <br />� i s �r i r� r t � <br />�ITY' C�►F EVERETT P'ERMIT SERVI+�E� <br />320a C�CiAR STR��T, E�tERETT, WA 98Z01 <br />425-257-8810 - FAX 425-Z57-$857 <br />� "� _...�r� /` <br />PFtOJECT AD[�RE$S <br />www.everettwa.org <br />t{., ►`` `F' l.�s..� Y1 f'1 t� cJ i'�lzi , "�s .`�'� � <br />Owtler Mai6 Address CiE� StatelZip Phor7e <br />Tenant <br />Mail Ac3dtess <br />Gity <br />State/2ip <br />Phnn� <br />1.�.--� t} l� � �... �.,.�, 1.+�. q'� t.� t�p t� <br />Electr3c�i �c,ntract�r tvta€t Address Gsty S9atet,�ip Phon� <br />�������� �a� � <br />�tat� i�ic�nse �lurnb�r �r�qu�r�d} <br />��� <br />Pra�osed Use o( Building � <br />Square FQotage (li �residerrtia! c�ew constructron, remodei or eddition) <br />Number of devices (if low voltage) <br />of Wark to Be Done: <br />...G�....� �--�� <br />�ITY t7F EVERETT E��GAL SA�ES "ffi1}C CG1DE !S 3'fU5 <br />�� �� � � <br />�€f� tr� �v�rett 8usiness Li�snse �lumber (requir�d} <br />��� <br />Contracf Price of Wprk <br />� '_�. ���a�.��'��� <br />Conl�ct PersanlCantaci Number�Emaii <br />t tzereby cerlliy that t h�vr� rea�t �nd ex�mined lhis �p�li�a�icar� �n�J kn�aav the �arne tt3 b� €rt�a �nd <br />correcf. Rt� �rovisians of laws end nrdrnances gauernrng this ty�� ai work wit! 6e cc�mpteted <br />v�rhether spe�ified herein ar not. 7�� grar�tirrg af a permil� dc�e� nczt �resume tz� givs euthc�rr'ty l� <br />viaiate r�i cancel the provisians of any ather state or locat /aw regulati»g canstractian ar the <br />parforrnance of canstruction. ihat ! am authnrized ky 1he owner af this property tc� perfarm the <br />work for which a,opliGaf+on is made �nd 1 conrply with the State Contraetors L�w � 8.27 RCW and <br />'�9 . 2DO 1�V,4 C. . , <br />S2EV15EU fiF3lt7�i/2094 <br />F�E <br />�� � <br />PERMIT# <br />� I� ( 0 -- �3 ( <br />