Laserfiche WebLink
� � <br /> E�..�CTR��pIL P��nll�`�' ��'��8���'8(��I <br /> CiTY OF E1fERETT PERNIiT �Er�Vir�.S <br /> 3200 C[DAR STREET, [VERFTT, 4VA 98201 � <br /> 425-257-8810 - FAX 425-257-8857 - �^n�nv.everetlwa.org 7 -a'-� <br /> C � �107 -01 � <br /> �J�7C') /?',�rrl// ('!�� I <br /> PROJECT.4DDRESS <br /> � <br /> �,�kx� �—�— I Z(�.�!rr/ ( �c��P���— �A� — <br /> Owner AtaJAddress CAy Slate/Zip Phone <br /> ���--� �� <br /> Tenant �.tadAddress Cny State/Zlp Phonc <br /> ���L_l2�zg /.br�h� -+ (�r_�r� Gc�- 98G_�'?� <br /> Elect�icalContracfor A4ailAddresS Cdy SIa1eILp Phone <br /> ��e�vl �� 9��CJ/� �11 GnD �o ��ry�.y <br /> Stale Ucense Number Contracl Pn�e ol b'cork ' " � ` <br /> ���-� � 5c�-�r rv�r��n Z��0�-3 <br /> Proposed Use o(Buitding Conlact Person (Plan Revie�v) <br /> Square Footage Qf residential nee+conslruction, remodel or addilion) <br /> Z ' �n__n�o-tor5 <br /> Number of devices (If low voitage) <br /> �,�� � <br /> Desciiption of�Vork to �e Done: �t✓l0(� ��(�(i�{����.L�� �� <br /> �`l1jA� �iU 1 lf"�-��T'L•{�S UL'111M.q_---�"L�/_ ��- <br /> V <br /> _y��N1�^C:�S C'��__Ldl�C� <br /> FEE <br /> CITY OF EVERETT LOCAL S�aLES TAX CODE IS 9105 � �0 v' <br /> I hereby cert�lylhal I have read and examined fhis applicafion and kno�v lhc same fo be(rue and <br /> conecL All provislons olla�vs and ordinances govemrng Ihis type o!work w�ll Ge comple(ed <br /> �vhefherspecdicd hereni or noL The g�anling oI a permil does not presume fo give au(honty to P[RMITi <br /> vrolafe or cancel t/e provisions ol any ofher sfate orlocallaw m9ulating consfrucficn or(he <br /> peAormance o( nsfrucfion. TAat I am aWhorized 6y fhe oV�ner o(this propert�fo peAoim 1he E I 4 O� — Q � � <br /> �vork for�vhich plication is made and!comply tvilh the Slate Conliacfois La�v 18.27 RCW and <br /> 296.200 WA . . <br /> �-2-?_�'`/ <br /> SignaWre Date � <br />