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To P:,pe 3 of 3 207n�09�0� 16 'A%(GMT) 186B8S74196 From Dav�tl Wyatl <br /> • • <br /> ��������A� ������� ��tl P,�.����9�91' <br /> CITY OF �VEI�EgT' F'I�FdMi�' �C�:VEC�CS <br /> i 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 • FAX q25-257-8857—�v��,tiv.everettwe.ory <br /> ! ` �_�f` <br /> i � <br /> SU� � C �C- /�E' tvr�; ;ar �G.� <br /> C I�(D�i–�3 <br /> IPROJECT ADDRESS <br /> �,��e SL3 ;� C l�-r� � < <� �, , <br /> �,��., , w-�c--v.�t�� �c:� , s ��� , <br /> Owner Ma�lAddres, C�ty Slalel7�p nhone <br /> nne ��if ___ <br /> Tenanl A1a�lAdtlre:e C;ty State�Zip Phone <br /> t (3;oe) ' <br /> � .���A+ �- C.IPc1riG7��c. -� O (��c�x �'`� - C�o.��� P t-c�l� s -��.-Gl$252- 454-CV�91 <br /> Ele- clricaTCoN�acto� f�7adAddress C�ry SlrteJ7ip Pnone <br /> WY�irtTEZ�1451�D OS3 - 2z-{- <br /> State License Numher(requ❑ed) Cdy of Everett Business License Numher(required) <br /> Go(�VIYV�erGi�G( � ---- ' .=°c� -`-- <br /> Piopose0 Use of BuiWing Confracl P�ice of bVork � <br /> Squere Foolage Qf tesidenliai new cons��ucllun,igmodel or addition) Conlect PersonlContact NumbedEmail I <br /> I <br /> Numbyr ol devices (tl lov✓vultage) <br /> � C!�S/ ' ( l C�'J ,L t`�.'�. / , / / <br /> Descriplion of Work to Do Done� �( 1� /Gq Pj(��C��� �( � �-�-{' Ge-« t(` <br /> �, > <br /> ,� `-�(.u,'�c'�iv S — � f �C_i�,� f�';�G�;�i 7`s ' <br /> � ' 'L <br /> i L/t _�1�:� 1--- L_G�J�. Zy�7.'l'_C�-".G��-:," / --------- <br /> I fEE C------- <br /> GTY OF EVERETT LOCAL SAI_ES 7AX COOE iS 9105 � O� JU� <br /> I IrereLy ca�fify Ihet!liavo road and ox;�nrineA fhis.�pppr2fion and lv�o�r fhe samo to be fnie and `' <br /> cormcf. MI prov�sions o7laws end o�din»ncos goveming this y-pe o/wo�k wiH bn cornplMed ----�� -�--------- <br /> v�hrfher;pecillcA hercln or not. ihe grenling ol e penmt does nof presume ro�ive aulhonfy�o PERMIT;t 111 <br /> violata or cancol the provisionc o/any ofhcrafaio orlocal lew rr.guln6n,q cnn.shucUon orthe � I � O� r ��� I <br /> peAomrance of consfmclion. TAa(I am authod.od by Ne owner oI�dis pioperty fo pedorm fbo <br /> wonr Ioru�hicb npp/icJio s made and 1 com,oly wilh!he Slafe Confrecfors Laiv 18.27 RCV✓and <br /> ?96.200 WA C. i <br /> ir <br /> / " <br /> �� <br /> ,i;,��____ �L=�� -i `-L-- <br /> —�;�a��.,� � -�9 <br /> -r----- <br /> REVLF11010940t� . <br />