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� ' :� . _.. <br />. <br />L�C`Tf�t� L PERIIi���` �►F��'i.���T1QN� �� <br />` � �ITY QF �VERETT P,�RiU#IT S,ER�l1�ES ' <br />320�3 CEDAR STRE�T, �V��TF� WA 98�Q�i <br />426-257 88� 0- FAX 425-257-8�a7.—�'!wuY-everettwa.aCg <br />. . _ _ <br />�� � � ��1..���c~;�U_ �, � �a � d„�; `� ��=�t=�`fi-•_� 1�t�'��"" ��'�-� � <br />PROJECi ADDRESS <br />��.� -�� f� �/�i C, L� �J"� � �..l�T `1 , <br />C��1ner Maii Address City st�te/zip Phone <br />�..�________. _ � <br />TeCtaT}t Mali Pddress Glky State/Z4p Phona <br />�ZSY 7�-8 t I q <br />A�,'i'1 v� �i� 1������. ��� 2A� �'x" � �,.'��c� ►��o� �1 � <br />F��cirical�����Contrac�o� _. MailAddresa � Cky���� StetelZl� � � pi�or�e � <br />,�C.TIV�`'��'+�..N15 C�2..62�f'�" , <br />State Llcense �umber (requi�ed) Clty of Everett gusir}ess Llcense �lumber (requ][eci� <br />�p -� � � 32� .ao <br />�`'� Propased Use af'Bul�ding Gonfr�tui Prica of Work <br />_.�__.�.r___ _ <br />Itl�r� UJALiu�ai �2�S-2t$� i?�} <br />Square Faotage (If regidentlal new cotistrUctlon, rernodei or additlon) Contacf Peraon(Contact Kumbed�ma31 <br />r � , <br />Number o devi�as If !ow volt��ej <br />{ g <br />: Descrip#lon of V�ork to Be Do�e; �.�'. �� 'y ��n 1 ���1� `.,,.�' �,i �`v' � i�� L �L""i�L � :._.S��.L� <br />�; <br />FEE <br />CITY OF �V�RETT LOCAL. SAL�S TAX GODE IS 31D5 � (�O <br />� �. ,,•� <br />' f hereby cerlJll' tN'af 1 have i�ad antt'��rrimhae�d thls:ep�ifeafion �nd krrav�r�the s�me to be true�and - <br />�,� � <br />corrac�. f1f1 ptodls(ons oflaws end ardTnancss goveming fhls type of work wlli be cotnplefed ' — <br />whetl�er_speai�red herBJn ornof. 'Tha grenttng v(a permtt dqes rtatp�sUm� to g(v� autharity to PERMIT# <br />vialate arcancel ths provlsfotts ot any ofhar state orlacal !aw regufaiing consfructlon or trte � J �'r �� <br />performance ofcanst:R.tction. ThaFl am authorized;by;he ownero�fhls properry fv perfarm tna E ��� �} <br />W a r k f a r w hl d� a p p!lca6 v n 1s made and t cWn pl y with # i�e Stafv Con f r�afars Law ?8.2� RGW and <br />286:200 WRC .__ <br />�.��- 5' �i�' l� <br />� �, � � Ignatur� � � E�ata � � � <br />�� <br />t�ev�stv o�roar�+nt� - <br />r: <br />__ _ __�fi�� ___ __ _______ __ _ _ ___ ,, ___ .(�Y�_ � �__ _ __ __ _ _G��_ __ � __ __ __ _ <br />� <br />