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� <br />� <br />_ ..�. . . .. :»,. . ,� , �. ,. g a t n. <br />. � �>. -:... , <br />,. . - , . . . ., �; '- . _.'; ' ' . al. . , . ' . , <br />" � ..., :, ` . • ��' <br />CITY OF EVERETT PERMIT SERVIC�� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� ��'��� <., �: <br />1 ��� � � i�� -�..� � � �� �, � :�--T--__ <br />PROJECT ADDRESS <br />�`�P� �'le;,�, <br />, <br />Owner <br />Tenant <br />; e �� �� <br />cal Contractor <br />�� r� � �`�S (� �o � �<�, <br />State License Nuinber <br />�,:�"� r � <br />Proposed Use of Building <br />���a � ��t�� �i r�, <br />Mail Address <br />Mail Address <br />Address <br />Square Footage (If residential new construction, remodel or addition) <br />� <br />Number of devices (If low voltage) <br />City <br />City <br />vCr-��C � �-J.� <br />State/Zip <br />State/Zip <br />�: � y �t� ��, k � ; I �, <br />Citv Sta <br />� J�`� <br />� �� C� , L>>� <br />Contract Price of Worl< <br />� �-��� 3 5 7�� <br />Phone <br />Phone <br />Phone <br />C��:� rK r,_� _ �'3.ci ��i-53 � <br />Contact Person (Pian Review) <br />Description of Work to Be Done: /'� O �/L � L v, �� �5 i�j V� � � � � S '1-0 �`'` �l S� ('✓ °C � <br />��,� ��K . �f /'�� ,_> 5������--� ,�� S � �c�k-�,,'S' fi��� ':- ,/ `L �� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby certify that I have read and examined this application and know the same to be frue and <br />correct. All provisions of laws and ordinances governing tl�is fype of work will be completed <br />whether specified he�ein or not. The grantrng of a permit does not presume to give aufhority to <br />violate or cancel the provisions of any other state or local law regulafing construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />l ` �— ��- .j , _ f L- <br />� � �--� � �-< l <br />Signature Date <br />FEE <br />PERMIT# <br />El�-�-O�j -� <br />