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� � <br /> -- -- -- -------- -------- --- - - - - -- <br /> � <br /> �' EL�GTRI�.Q►L PCRMi I�4F�PLC�is►TIQN-- - - � <br /> ; CITY OF EVERETT PERMIT SERVICES <br /> , 3200 CEDAR STREET, E'✓ERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - wwtiv.everettwa.org <br /> ��i3Z C�lby �ti,�� <br /> � PHOJEGT ADDKESS <br /> C� (b,� ��' ���rl�,,;5 L�� �� C�1G� r�Y F��t;rii� a�zvl — <br /> �. Ounnr fda�l q��rc.c C�ty SWtC/dp Phone <br /> Nt�rrv��,,J C�� 'y��3L c�/Gr /l�-�w �vr,:���.,:%1- 4�av1 c/zs ziz7s3s <br /> i i�en�M h1aiACOress C�p� St;tel2ip Phone <br /> i <br /> � <br /> (�/,/u71`�/Pc/r ,c LOS' G�fG.,�y S% l.✓��,,,t��/l> lurr ?'�'��Z �%Z�5�7J�'ysl <br /> �IeGIIiWI Vt1nI1dC�Uf I.1J:�AC�fciS G[y S1utC2�0 �'�CnB . <br /> �•a: <br /> (��jGr �! � y ti.S�/� �V 5 V ` <br /> ;i'dte L� enSe NWnbcr CC11If3C[PriCC Of lNork <br /> I 1`roposcd Cse of lludtling Cunldci PtlrsUn (Piun Review) <br /> � � <br /> I <br /> I Squere F�otage(If resideNial new construction,remodei or addilion) <br /> I � <br /> � Number ol tlevlces(If low voitage) <br /> IUescrlptlon oi Woik to F3e Done 1�-'i Cd.y✓,�P c i �."}:-�5{; '—. 4 (_ _:._�/� � l�"��/s+c: e (� <br /> .� / <br /> i �-PCt:�i-r .-� ec,� �,�>.5�'.,�_ !_ �h ��� fzJ iv_t ��> ��t:^�<, � P _ _ <br /> i <br /> ,I <br /> (=[E / ^^^��� <br /> I CITY OF EVERG7T LOCAL SALE5IAX COUE I5 3105 � //���� <br /> \l� <br /> 1 hrreby cerlily thaf�bave iead�nd exanuned!lrrs�ppiicaLon and know tho s�mc to be huc and i <br /> roirec/. �II provisons ol laws:�nd ortlinancos go��eming this typo o!�vak�rill Le completeC <br /> �:lrether sper.ifred fre�cin ar noL The gianbrrg uf a pcm�it Coes not pmsume(o�roc aulhority fo PERPIIT« <br /> i �,c!ate or wncol mo piovis�ons ol eny othcr s:aln orfnc.�l faw mgu�atmg consln�ctioi�or the C I �I � — O�� <br /> pc Aom�onto ol consfrucfion. TO�H t em aulhonzed hy(Ae ownnroi fhrs p�operry fo pe�t.�mt fho L � <br /> i nvrk loc�v6ich�pplic&ti c mnde and 1 canply wif�fno Sfate Conbac�ors L,ia�iB1%RC4V arU I <br /> �i 396.200.1M1'AG. � <br /> /2 � <br /> ,-�"���.�G���. i z�Y/i� ' I <br /> �£'fgnaWrc Oate — <br /> ✓ <br /> �_.-�o;:::�� <br />