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E�.ECTi��Cp,L PERMIT APPLlCATION <br />CITY O� EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVCRETT, WA 9f3201 <br />425-257-8810 - PAX 425-257-8857 -www.everettwaArg <br />APPLICATIONS ARE ACCEP7E�7 FROM 8 AM T� 4 PM <br />� - o -i. ���a.. <br />i PROJECTADDRE3S <br />i <br />I <br />IUwner <br />li�i'1 <br />Ter,ant <br />i'�c��v•,n [ <br />, rle�idcol Contracivr <br />Mu;l Addreca <br />Churc <br />Mail Address <br />� �� <br />M.ilAddrass <br />��R�az��aRt cs <br />S[ate License Nombcr <br />C�m�,��.A <br />i'roposetl Uso of Ruilding <br />Square Pootege (If tesitlential new wnsWctlon, remodnl or nddition) <br />; Descrip!ion of Work W Be Donr.: � e W 1(� � <br />VOTE: WIRING IN NON-DWELLINGS IS REQUIRFD TO <br />BE IN RACEWAYS, MC OR AC CABLE, <br />cITY OF EVERETT LOCAL SAL63 TAX COOE 133105 <br />C;.y <br />City <br />City <br />State2ip Phone <br />Sta�e/Zlp <br />Slate2lp <br />Phofw <br />l 3bo> <br />Phone <br />�ai�� <br />Contract Prlce of Work <br />�a� y25���3 3� <br />CaptdCt Persan (Plan ?evir,w) <br />!!roreby cenily dret I hove road and examlocd fhis applicafinn and know fho same io bo tnie and <br />r��nr^c(. Afl provisions o/laws and orc/lnancas goveming this rypo of wnrk win be c�omple�,'ed <br />.:hethorspoC�ed hemin or not TFre gr�n(Ing of a pomirt doos nof p�esumo to give autho�ity to <br />�;:-�Inty or eancel thu provlsions o( any aUrcr stafo or local Isw m,qul�fin3 construcflon or fh,e <br />r^rlormancn o/ r.ronstrucffon. 7hat I+�m outRonzod, by fhe ownor o! fhls prcperty ro peAom: the <br />:-u�k /or whicli appllenfion is made and I comply N+t6 fho Stofe Confn, c(or, L+3w fC27 RCV✓ ond <br />, . �.,., �.,.� <br />FE� <br />10-1 � 30 <br />L � ?7�0 - 0 �� <br />