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�LEC�'I�lCAL PERIV��T APPL�ICA�fON <br /> CITY OF EVERET�I" PERMlT SERVICES <br /> 32ti0 CE�7AR STREET, EVERETT, WA 98201 <br /> 42�2a7�810 - FAX 425-257-8857—www.everettwa.org <br /> APP�,�CATIONS ARE ACCERYED FROIfA 8 AM TO 4 PM <br /> �� '� I , 1 S �� <br /> PR0.fECT AODF2ESS <br /> �������� 2 � � .� �l� � / �/ d��� <br /> ONA'19f Maii Addrer,s Gf�r S 21 Ph017e <br /> v V <br /> 7eilarlt _ MaIE Adtlress CitY siate/Zfa Phone <br /> � �� � 2�� � �� 2 <br /> ��8Ct/1C81 CDF1£f&dOf Mekl Addi'BSS City St&te/ZiP Phonc <br /> re� ��e �g � � � � �oo . o � <br /> tate Licensg Number Cosi7aCt PrfoE of Wark <br /> U � � � � �� ��� � <br /> Prop4sed Us�of B iEd' g C4n pe►son (Plan Raview) <br /> Square Fqotage{ residential new conshuction,remodel or additipny <br /> Descrip�pn of Work to Se Done� �QV � <br /> NO��: WIRiNG IN NpN-DWELL{NGS !�REQUIRED�'O �� <br /> BE I�i f2AC�1NAYS, MC OR AC CABL�. <br /> CCFY OF�Y�RE'fT LQCA�SAL-ES TAX COp�(S 31a5 �D' D� <br /> I hereby ae,�y�et I heve read and examinae mis application 8nd know tt►e seme to be tiue and <br /> COnBct. A!I proVisiOns of fews and onfin&ncesgove m!n this typ�of wprlc will be opmplet�d <br /> vvheth@r specitlad herein ar not- '1'he grandng 4f a pe�m�does�t pie�me to give auttrorrty to y� /�/.��,(!1 � <br /> vrolate or cance!the provisions of�ny o�er state or local law ra ula6n consbUction pr the U <br /> Pe�annance ot carstiuGtion. That 1 am authonzed by the armer of this ropgRy to pertam the � �J <br /> work fr�r whfCh 8pplication is made and I comply w���a(����Law 18_z7 RCW artd <br /> 296, DO WAC. <br /> �� <br /> 9�� ate <br />