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. �— ! — <br /> ������o��� ������ ��������o�[� <br /> �I��P �� EV�RE�'�' ���MI� ���`d/9��� <br /> 3200 CEDAR STRE[T, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -vv�vw.everettwa.org C��� g-1 S <br /> � � 5���i9 <br /> \ � 3a ���,� ��t <br /> PROJECT ADDRES <br /> /�c . �av n� ,.�a ��o�� �1�� r�csr�- WA �las -aso2�� '8 <br /> Owne� � NlailAddress � City Slate2ip Phone <br /> Tenan� MailAddress Cily State2ip Phone <br /> �c k'•� �1c_c_�5`,t. �3���G 1�5 S�f' � Gi�k���c.�atls �J,A 4E�25� a•C�-�rl 5- 3� 6 <br /> Elec�rical Conirador 49aiinddress Ciry StatelZ�p Phone <br /> ��'�� F�.�Sn►. � ��� SS <br /> Stale�icense Number(required) City of Everett Business License Num6er(required) <br /> ` ;.,`�s 1 , f�c��� _ <br /> �r� . --� <br /> Proposed Use ot Building Conlracl Price of Work <br /> �,�,� 2.ob�9(5 -���6 <br /> Square Foolage Qf residenlial new conslruction,remodel or addition) Conlacl PersonlContact Number/Email <br /> Number of devices (If low vollage) <br /> Description o(Work to Be Done: !�\��W\�w �t.� ��JQ-`�,��_ <br /> 1 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 '�L� �b <br /> I l�r.reby certi(y thaf!havc read and examined(his applir,afion and know llm samc(o br, true and _—--_. _ <br /> coirecL N!pr�visions o/laws and ordinances goveming(his(ype o/wod<wiN Ge completed - - <br /> �vhelhcrspecilied heiein or noL The granfing o/a pcnriit daes not presume to give au(hority to PERMIT�t <br /> violo�eorcanr,ellhepiovisionsoJanyofhr.rs(afeorlocallawregulatingconsbuclionor(he � ��D � _ I�^ <br /> peAoimancc o/%onstn�c(ion. 7hat I am aidhonzr,d by thr. owncrol this pioperty to pr.r/onn lhc �� <br /> wmk Por whicA applica(ion is madr, and I comply with Ihe Sla(c Conlracfors Lae� 18.27 RCW and __.___.____ . <br /> 29G20�lyAC. <br /> _ <-.��1 ---� a��5 A���- - <br /> Signalure �����' <br /> rtm5rnnn�n,,;mr.p . _.-- __ -._ --__ . <br />