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� • <br /> ���������� ������ ����������� <br /> CITY OF EVERETT PERMIT' SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �// <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �_ a� �- �i� <br /> � 1 �lD�"� �� <br /> I `-f 18 (N�--�b�.� /�,-e <br /> PROJECT ADORESS <br /> {��yC.+e I � SJ ��� d W hciG �11f— I�C 2/�V �r"ltat�P� \ �Z) �Z�e��y <br /> Ovme� Mail Address <br /> 78nant H1aitAddress Cily S�ate/Zip Phone <br /> �� VVI ` V <br /> EleCtriCal ContraCtor �uiail Address City Slale/Zip Phone <br /> Slale license Number Conlract Price of Work <br /> Sr �� CoNacl Person (Plan Review) <br /> Proposed Use of Buitding <br /> Sqvare Foolage Qf residential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Descriplion of VVork to Be Done:(�� �..X�e Z � ✓f��-n�'�c`f � ( ��}�'`� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 � � �� <br /> !he�eby ceRily lhat 1 nave read and examined fhis applicalion and kno�r+fhe same!0 6e Uue and <br /> correct All procisions of la�vs and ordinances goveming fhis type ol work�vill6e comple(ed <br /> whether specilied herain ornoL The gren�ing oI a permit does not presume to give au(horify fo PERMIT� <br /> violate or cancel(he provisions o/any olhersfate or local law�egulafing cons(rucfion or the E ���� � 3g <br /> per/ormance ol construcfion. Thal 1 am aufhonzed by tne owner o(fhis properfy to perform the <br /> �vork(er v�hich applicalion is made and 1 compty veifh the Sfafe Confracfois Law 18.27 RCW and <br /> 296.200 WAC. <br /> � �.�� S�a� 1 i <br /> Signature Dale <br />