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O5IZ8/2014 O3 11 k4753 ° OO1/OO1 <br /> �LECTi RtCAL PERMIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-25'1-8810 - FAX 425-257-8857—www.everettwa.org <br /> �� a�✓t�. <br /> � i����_ 1�7. <br /> aY23 Lo� B�nl1 <br /> PRUJECT ADpRESS y�� <br /> 31q S�s '� <br /> �� s� �?��d ayz__Z_�;�3,u��� ���� � <br /> Owner MailMdrexs Clty SWIC2ip Ph00C <br /> 7enant MuilAddress crty s�arc.2+v U., n Pnone <br /> � �J <br /> 6�1�A�D;�L �1-�—��.rGIC � ��—�'-(/fj��'i,l'T���al .�'1 ,2/C� <br /> FleciricaiContrador MaIlMtlresc � City SYale2ip Pnone , <br /> ��tiss��z�n � ya � � <br /> I <br /> State License Number Conhact Price of Work <br /> Froposed Use of Building � � COntad Person (Plan Review) <br /> Squar�Footage pf residential newwnstruction, remodel or additlon) <br /> Number of devices pf low volteg0) <br /> Oescription of Work to Be pone: ���) /—_ �/IA��//]il�/�l( ��� 1/t/ <br /> ��l� (��-a�',� <br /> FEE �� OQ <br /> CITY OF EVERETT LOCAL SALE$TAX COpE IS 3106 � <br /> � lJ <br /> I homAy certdy B�at I hovo read and exeMnod!h!s 9pplicaAon and know tho sar.�e fn be We and <br /> correcf. All provisions of laws and ordinancorr gpvemin9 fhis typo o/work will bo complefad <br /> whother apecifiod horein ornot Tho p�nting a!n pormit does nut prvsump ro givo aufhonty to PERMIT# <br /> vlolalo or cancol the provisions oI uny othor str�ta or;ocol lew rw�ulqting constrtiction or tho <br /> peAormance o/construc0on. 7haf I am authonzetl6y tho ownero�lhis pmperty(o perform fhe E + �O � '_ I� � <br /> wodr for wh� applrcotion rs made and I comply with the SYato ContiaCtors Law 18.27 RCW and � <br /> 296 200 <br /> J yt <br /> OO <br /> i n re atc <br /> R ISED126'�9 � - �� � <br /> o I <br />