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To: Page 2 0( 2 2014�OB-12 2339A� (GMT) ��BB8574196 From Davitl Wyatt <br />. . . , . � .. .. - . . . . � .. .� � S . . . . . . . . . <br />■ <br />������9���:����9`�" ����6���'��� <br />c0z� o� ���€����r ������° ���v���� <br />3200 CEDAR STREET, EVERETT, WA �J8201 <br />425-Z57-8810 - 'FAX 42.5-257-8857 - www.everettwa.org <br />�=iy0�'--c�7i . <br />' .. _ _ , . � � :.. ��i S -1 � _ <br />cb 1\ Ni�.d�50-, � E�P��{-k, c,JA. ��Ss�Zo3 <br />PROJECT ADDRC-SS <br />Owne� � � � IdaIl.Adtlress. - � - - ��CIty � - � State2ip .. �� Phone <br />�vn.r�sP SP�v;cP �b11 lUladtson �J?�e�� (,�/J`}. `�ZCj?7 <br />Tenant MallAdd�oss �- � City � � � StalelZip . Phone <br />(`��o) <br />(,Jva-I--1- EtPc�ric��c -�Oi3ox ��-G-ro..���e t-nlls-WA_'Q�252-�5�-C <br />ElecMca Contractor � Ma�IACdress � - - _ ` _Cily-. � � � State2ip � � ' Phonv <br />WYA7"TF_=�t45'PD <br />State Li.ense Number (reqqired) � - � <br />Proposed Uso of Building , - � - - - � . <br />. Square Footage (If residential new conslrucdon, remo.del or addlllon) � <br />Number of devices (If low votlage) � <br />City of Everett Business License Num6er (required) <br />SC�U "� <br />�Conlract Prico o( Work � <br />Contact PersoNContact NumbedEnlail <br />�escription of Work to Be Done: l �l 5(� �l �� w �`� G�' �u/ ��� r� � i <br />Izt:�c) � `�-o �7 c>✓t -� �" _ <br />FEE <br />CITY OP EVERETT�LOCAL SALES TAX CODE IS 3105 . � . �% 5 d <br />I hereby coRify fhat 1 have road and examined this applicatlon and know fhe same to be true ontl � �J l <br />coRecl. A!! provisions of le�vs and ordinances govem/ng this�type o/ woric wil! be completed . , <br />�vhelbersPecified herein ornot. �The�gianting of�o permif does nof p�esumo (o give au(honryto ��� PERMCf#� � <br />violnte orcencel �he piovisions ofany othorctate ori�calla�u regula(ing constructlon or the � <br />pedo/menca of conslruct/on. Tha( I am au�Bonzad by fba o�vnerpf thrs proporty to peKorm tho � E I .� g— O� 7 <br />ovodr /or which applica '� � s mode and I complY withlhe.5tate Contraclors Law� 1827 �RCW and �� <br />296.200 WAC. . . . - - . . .. .. . . . <br />. �� � ... . . � . . , . <br />�'�Z-l`- <br />SlgnaWra . , . _ . .. .. ._ .. _ . Dato . �. -.. - - �... , , ., .. . . . �_ . . <br />� /� . � . � . . .. �- . � . . . . . . ' <br />REWSEDC&05l101� <br />