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PROJECTADDRESS <br />Owner <br />�, <br />ELtGT�ICAL PERMIT APPLICAI"ION <br />CITY OF EVERETT PERMIT SERVICES a� r,.� <br />3200 CEDAR SIREET, EVERETT, WA 98201 !� <br />425-257-8810 - FAX425-257-8857—www.everettwa.org L �2p7—«3 <br />APPLICATIONS ARE ACCFPTtO FROM 8 AM TO 4 PM <br />Mail Address <br />.� <br />Mail Address <br />� ;� <br />Mail Address <br />CI��� ��'��,�c,� <br />51 (e License Number <br />Proposed Use of Building <br />Square Foolage Qf residential new conslruclion, remodel or addition) <br />Work to Be �, ne: �C�'1 1� C�� <br />Yf/� � 1� �� � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CAI3LE . <br />CITY OF EVE�2ETT LOCAL 5.4�_[S TAX CODE IS 3105 <br />City <br />City <br />State/Zip <br />C� <br />�v�� <br />Phone <br />�� <br />L� � <br />Ph� one <br />2� 2��3 <br />�3 <br />Phone <br />Contract Price of Work <br />mILK— ��/ �'���_� <br />Conlact Person (Plan Review) <br />1 hereby ce�ti(y fhat 1 have read and examined (his applica(ion and know Ihe same b be true and <br />correc(. All p�ovisions olla��✓s and ordinances govem�ng this type of �-;o�k will be compleled <br />tvhether speci(ed hcrein ornot. 1 he yran(ing o(a pemut does notp reswne to give aufhonty to <br />violate orcancel the provisions of any ofher sfafe orfocallaw regulating construction orlhe <br />pedonnance o(construction. That I arn authonzad by (he ormerol thisp rope�ty fo pe�form the <br />�vod<for �vhicb application is made and 1 cornrly �'�i(h thc Stata Confraclors Lm�d 18.27 RCW and <br />2Q6.200 WAC. <br />. <br />// // � <br />f" , /'� .. ` � __n�.f� � ! �// l <br />� <br />� V <br />FEE <br />�� � z-� `� - I I 7 <br />�� <br />