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� __ <br />• <br />! <br />EL�CTRVG�IL PERMIi AF��LBCO�i��6� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, �P1A 98201 <br />425-257-8810 - FAX 425-257-8857 - ;^nv�v everethva.crg <br />�v� s� �,��� i�� �v _ <br />PR�JECTADDRESS <br />I�r �, Ku D � n <br />Ov�ner <br />Tenant <br />���ln i 5 K /e <br />E!edrical Cantredor <br />�.1adAtldress <br />r,tail nC"•r.ss <br />i.'a�l Adtlress <br />� /�c��a31c� <br />Stale License Number <br />Proposed Use of Building <br />Square Foolage (It residenlial nev� consfruction, remodel or addition) <br />Number of devices (I� low voitage) <br />Description o( Work lo Be Done, l <br />�� 1:�� <br />--�-o � N-� �� 2�-_v � <br />CRY DF EVERETT LOCAL SALES TAX CODE IS 3105 <br />CAy <br />GI� <br />Cdy <br />s_�� �� <br />C , c�os-ay3 <br />StalelZip <br />Slate/7_ip <br />S�alelZip <br />� I �'� _ <br />Contra �t Price cf Vdork <br />Contacl Person (Plan Review) <br />I hereby ceR�ry thaf I have read and examined this applicafion and know (he same lo be frue and <br />correcf. All provisions o(laws and oidinances governing this (ype ol u-ork �vd! he comple(ed <br />�,vhe(her specilied he�ein ornoL The granfing ol a peimit does nof p�esume (o give authonty (o <br />violate or cancel fhe provisions oI any ofher slate o� local law iegula(ing conslnir(ion or the <br />pe/formance ol conslrucfion. That I arn au(honzed Gy Ihe owner ol this prope�ty (o pedorm the <br />�ao�kf.�r ivhich application is made and I comply wdh lhe Slate Conliaclors Law 78.27 RCW and <br />Phone <br />Phone <br />fa�l <br />fEE <br />��•�� <br />PERMIT�! <br />E��os-o�3 <br />- <br />