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Nov,25. 2015 4:04PM Store755 <br />No.7010 P, 1 <br />�L��`�RI�A1� P�RIVI�T APPL��A,�'�O� <br />C�TY OF �VER�TT PERMIT S�F�,VI�ES <br />3200 C�DAR STRE�T, EVERETT, WA 98201 <br />425�257-8810 - �AX 425-257-8857 — www.everettwa,gav <br />�{ Z�( �3�2o Ab w�y �v��c-rr . Wa _ <br />PROJEC'i ADDR�SS <br />6 ��� �p <br />� G� 90 03 v <br />OWner Mall Acldress City State/zlp Phont� <br />!t <br />7onant <br />t� <br />Mai1 Address <br />�(L 1"' � M C+ 1..0/Y� m L.) 1 S V <br />Electrica) Conlractor Mail AdcJress <br />T21��_ �' �� � O�-1 <br />State License Number (reyulred) <br />i c. � - <br />Proposed Use f 8uflding <br />Vc. <br />.L�dt� --. <br />Syuare Footage lf resi ei�tial now conskruct�on, remode! or addillon) <br />3 �t <br />Number of devices (If lo�v voltagc) <br />Cily <br />City <br />�{ �/ <br />5fate/Zip f'hone <br />z5 5� <br />1 l rn 4v,..��i SSoZ � <br />St2t�j/ZiE� <br />(�3 b42'� <br />Clty of Everett �usinass License Numbor (raquired) <br />����09� <br />Confract Price of Work <br />��c z_ ���5�1 _ <br />Cor�tact Porson/C`oi�tact Numb lEniail <br />�����'t or� (� `�2 I �Ttzc. . Co�n <br />Uoscription of Work lo Be Done: �� �p�'('�� �In� (�„ �- ��� (a.�(t,� ��_�i,.��,.� <br />+ ��� <br />�_G�? Q V�Fi' t.� U�F I Gv s <br />CITY OF EVERETT LOCAL SAL�S 7AX COD� IS 3105 <br />/ l�ereby certify tilat / l�avo road and ex9m/ned lhls a��lication and know tho sarno to bo trua and <br />r,or�ecl. �lll provlslons of Isvus and o��dinancos goveming thls ly�e of work wlll be cornJ�leted <br />tivfiothor spcclfied hereln nr noi. Tl�e �rantrr�� of a pormit doos nof presume to glve sulHorlly lo <br />violate or caricel 1ho ��rovisions of �ny o1Her s(ste or focal law re�ulatir�g consfri�ction or fhc <br />per�ormance of consfruclion. 7hat / am authorizcd by the owner of tl�ls pro�eriy to peiform the <br />work for wliich appllr,a(lon /s made and I can��ly with tho Sfafo Contracfors Law 9�.27 RCW ancl <br />296, 200 . W�1'C""J"'��.,� <br />c___ <br />aeviseo os�csna�a <br />��� � <br />�� � <br />P�RM17# <br />E 9���q- �� 3 <br />