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�- - <br />� <br />� <br />EL���'RI�AfL �PE��illii7' �,�'�LO��41foU�+l <br />CITY OF EVEREI'T pERMIT SERVICES <br />3200 CEDAR STR�ET, ': VERFTT, UVA 98201 <br />425-257-8810 - FP,X 425-257-8857 — vnv�r✓.everettwa org <br />I � <br />I�30�/ �✓�S/ ���(l�fi O � _ I <br />PROJECT ADDRESS yZS-3S� �/Ur, <br />� ��� G� _5��� W�s� /����G�T� �i� �V�WP�°/ W�9�3 _ � <br />i�— C.t Stalc2ip Phene ' <br />Ovmer �:ta�l Address 1 <br />� <br />, Tenanl tvtadAtldress C��;y State�Z�p Phonc I <br />N2s 76� _ � <br />I C�a-i'�r S,E��'LlY �L 73� �Gi�'I S�-�f/�✓ `�9G✓cr� L�'A G�Zi2- �"�s8� � <br />; EleelricalConirac�or tdadAdCress C�ty State!Lp Pnone ' <br />��wr� e i � 3rf �% <br />Slate l i�e� �e Number (reqcred) <br />Proposed Use ot Build�ng <br />i <br />I Square Foolage Qf residential new constri:ct,en, remudel or adddion) <br />Number of devices (If lo�v vollaye) <br />0 5 3 S Og <br />Cdy of Everelt Bus�ness'_icense Num6er (reqwred; <br />[��p G O <br />� ------� - - <br />Ccn!ract Price of'Nork <br />7u�b �lZ �- y6G- �s�� � <br />Contact PersonlCon!ac� Number�FinaJ <br />I / % /1 <br />� Descriplion of Work lo Be Done: (��` u/,%� 5�( �7 H�3'.�.- /��f.tltj7-- <br />— � % <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />, <br />�I hereby ce�tdy Il�af 1 have read and examined fhis applica(ion and kno�i fhe same to be 7rue rir.d <br />cormcL All provisiens ol/a�vs and ordinances goveming Ihis type o! �vork u-i116e cornp/efed <br />I �vhefherspecilied he�ein or noL The gran(ing o/a permif does not presume to give authonty fo <br />Iviolateorcanceltheprov�sionso/anyolherslateorfocallawregulalingconsfruc(ionorthe <br />per(ormance o/cons/rucfron. That ! am authonzed by fhe o�vner o/fhis property fo pedorm Ihe <br />� ��urk for �ehich app�icalion rs made and 1 compty �sifh the Stafe Confracfors La�•� 18 27 RCV'✓anJ <br />, 296.2001�✓AC. <br />! ����_ � �-3-��J <br />� Signaturc �atc <br />-- --- � <br />I <br />-- I <br />FEE � <br />5��� , � <br />I <br />�FRrin�,� � i <br />E � 503 - DI � i <br />� <br />I <br />� <br />� <br />� <br />