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�����'�9 G��., ����i3'�A� �i���a��`�'B�� <br />Cii'Y OF EVk����" �'�R+VII�' ��FZ�/IC�S <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – www.everettwa.org <br />� S� �1 � V� ��� R F� uJ W�-Y <br />PROJECTADDRESS <br />,D��s�v C�u�e«.� 6�t�Z��� <br />Otvner Mail Address <br />Tenant <br />Mail Address <br />/ <br />��S�j _��S <br />C� ` ZZ—� S <br />�vE�2�r,�- 9�'ao 3 <br />City <br />City <br />Slate/Zip <br />Slate/Z�p <br />Phone <br />Phone <br />b�-L�c��v F L�c�ic LZC �7.�� .a.29��'PZsW F�n�oN-�s ta�- <br />Eledrical Coniractor MailAddress Ciry State2ip Phone <br />�A-Lu�� c� ��a �o <br />State License NumCer (required) <br />Ptoposed Use of Building <br />Square Foolage Qf residenlial new construction, remodel or addit�on) <br />Number of devices Qt loei voltage) <br />Description ef Work �o Be Done: <br />N <br />PP L � <br />P� U� p <br />! %i �/ I <br />i���' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />ZPzJZ� 2 <br />Cily of Everett Business License Number (required) <br />J'vv•� <br />Contract Price cf Work <br />Contact Person/Contact NumbedEmail <br />P�,q/�t�-�9 ��x�-kus <br />1 hereby cerfi/y thaf I have read and examincd this application and know fhe same fo be lrur, and <br />correcL All provisions ollaws and ordinances goveming this lype ol work will be completed <br />�•�belherspea(ed he�ein ornot. The granting o!a permit does no( presume to give aufhonty to <br />violate or cancel the provisions o/ any ofher slate orlocallaw regulatinr� constructron o�(he <br />perfoRnance o(conatruttion. That I am authonzed by lhe owner o(this propert� to pedomi the <br />�vodr !or v/iich application is ni7�e �nd I comply wifh the Sfafe Confrac(ors Law 18.27 RCW and <br />296.200 WAC. , // <br />�/a �-/-�S <br />nevisea a�as�oia <br />e/ Z G u{;� S <br />FFE �,y� <br />I �� o � <br />PERMIT# <br />� �S�D�"�"15 <br />