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• 2o""r-0 <br />0 <br />+6"'.L�,OF, 100oo'3I.". rr.m. Cane,. W,. <br />UfY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREl1 , VVA 98201 <br />425-257-F810 - FAX 425-257-8857 - www.everettwa.org <br />G3c> ML)�f s/,, Z, <br />PROJECT ADDRESS <br />6,3v /lfc.,,,A xc--., Lr/v�- 78 Zv / <br />Owner Mail Addrgcc City Stale/Zip Phone <br />Tenant Mail Address City Slate2ip Phone <br />'U-ltfu(r�Iec(r.c T-o-( fili%s w44 gYzsz <br />Elec ical Contractor Mall Address City StatelZito 051!Anne <br />o r <br />/.t%vU77 e ZSZ�)U"' <br />State Li case Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />45z) v <br />Square Footage (If residential new constructionremodel or addition) <br />121- <br />Numb r of devices (If law voltage) / f <br />Description of Work lu Be Done: / 5 l�rli ''V�w <Gr oa Lrrjf i �S cJv t%+' �J <br />s <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX, CODE IS 3105 -�7 Q� <br />f hereby certify that I have read and exan tined this . nplicalion and know tho sima to be true and f/ <br />cotter.!. All previsions of laws and ordinances govomrrg this fyrd of work twit be completed — <br />whetherspecihnd herein ornot. The granting of permit does not pres are to give aulhonty le PERMIT# <br />violate or cancel the provisions of any other state crloeal law rogulahng 'struction or the L <br />performance of construction. That 1 am authorized by the owner of this pr. erty to pertomr the � <br />work for w /�q liCaliory�s rode and I corn I with the 5fate Clntnctorz Law 18.27 RCW and 1 YJ <br />Pea Dn �rf/ 1 J p y - _-. <br />%1` ,Y—i3 <br />