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�- ------ - ---- -- <br /> ����������. ������ ������� � ��� <br /> C17Y OF EV��E�'T �P�RMI�' ��RVICFS <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —ww�,v.everettv�a.org j <br /> I <br /> ��so9-/6 Z- <br /> �.�� 3c�7� sT __ 9� zr� ,S� <br /> PROJECTADDRESS <br /> Q 1_ i r ' ,.� /�(l� ..�.f ��r,�� �/� 9��a! - <br /> Ovmer MailAddmss City State/Zip Phone <br /> iTenant a�a�ind�ress ci,y S�ate2�p Pnone <br /> l.�r- Spn�;� � '3� t',o�6x 711 ������,..( �,�� �i �y� a� ��5 � <br /> Flectrical Coniracior Mail ACdress City State2�p Phone <br /> ��� � a`�� J�J ��� � (�3 <br /> tate�icerse Number(required) City of Everett 8usiness License Number(required) <br /> Proposed Use of Building CoNract Price of Work <br /> Squ�re Footage(If residential new construclion, remodel or addition) Contact PersonlConlact NumbedEmail <br /> Number cf devices Qf loai volfage) <br /> i <br /> Descriplion �i Work to �e Done lJ� ��!� �l 1 ��G� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAJ( CODE IS 3105 ��/ Q 6 <br /> / <br /> I hereby cedr/y lhat l have read and cxamined this application and know the same lo be hue and <br /> correc(. All provisions o/lav✓s and ordinances goveming lhis type a(�voik will Ge comple(ed ------� <br /> v�hefher specified hereirt nrnot. The gran(ing o(a permit does nol presurne(�yive authonty to PERPIIT(I <br /> violate or cancel lhe provisions of any others(afe orlocal law regulating construction or fhe <br /> perlomiance o/cor,structiorr. That 1 am aufhonzed by(hr. o�vne�ofthis property to pedomi fhe E ��OG_ r/.,� <br /> �voik lor whrc applicalio is made and I compfy with fhe Sfafe Contraclors Caw 18.27 RCW and � Ur <br /> 296.200 f . <br /> � �a r -.�s� <br /> 5 nature Dale <br /> REVISFD OL9L?0/< <br /> _- _--_ ___- .___. __- ____-_ -._".__J <br />