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� <br /> ���� li� G:zOCGa�-, p��3��1�� /����AG,��i �OO �I <br /> �B d� �� �4/�����" f��I�G�89�" �f��F�IC�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � ��O-�� S � <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> C�So9 -�� <br /> � � � ��l 2�9 0 0 pP ��� � <br /> PROJECT ADDRES5 <br /> �r,����� �1� ��� �c t�� �v �6 GI�N��� �vese�� (,�c>�> 4srS's � <br /> Owne� �ailAddress City StatelZip Phone <br /> Tenanl MailAddress City Slate/Zip Phone <br /> As ;a I ��i','�T� e /�i�iG' �2�i�«� �'��,���w� p� o�ti r�iz�� 7 3 /��3� <br /> EleclricalConiractor MailAddress City State2�p Phone <br /> � �� 1�� <br /> State License Number(required) City of[�rett Business License Number(required) <br /> Proposed Use of Building Coniracl Price of Work <br /> Square Pootage(If residenlia�new conslruclion, remodel or addition) Contact Person/Conlact NumbedEmail <br /> Number ot devices(If low vollage) �`�1�� <br /> V vl � <br /> Description ot Work to Be Done: ������� ' �e�� Y/ � � ' �'`^-' � <br /> FEE <br /> CITY OF EVER[TT LOCAL SALES TAX CODE IS 3105 �dl.. I '�1 ` o� <br /> l'f l J <br /> I lierrby ceitily(haf I have read and examined Oiis application and know Ihe same lo be hue and <br /> correcf. All provisions of laws and ordinances goveming this type of work will Ge complefed <br /> whc(herspeci�ed he�eiu ornoL The granfing of a permil docs not presume to give autho�ity fo PERMIT# <br /> viola�e orcancel lhe provisions ol any othe (ale orlocal law regula(ing const�uGion or the � � �„/�� �r <br /> perlormance o(construction. Thaf ionzed Gy the ownerol Ihis prope�ty fo pndontt fhe U� � �\� <br /> work fo�which ap licafion is 1 r,omply witl�the S(a(c Conl�actors�aw 18.27 RCWand <br /> 296.200 W . <br /> , <br /> � � /�O r �� <br /> s� �w�o n,io <br /> HCVISFO08/J6ROI0 <br />