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�-�` g s-- r.� �.- � i� € � � ¢ � e— �� � � • � � � �� � " � � ;�. "� ° "� r �, <br />< .� ; .� ,� <br />_ �" ; <br />, <br />, , � <br />, � • -- �' ;_. . ; <br />l <_ r`� \ {�.� f � = 4 � i � E ��. v - - '��,.� <br />�I�l( OF E�/E�E`�`� �E�MI`� ��R�ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�� f� Z.��`�`'-' �� � � G�� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />�`,� � �w" �� -�'i� �'���� J� J�-� �lJ ��-C <br />Mail Address <br />Mail Address <br />City <br />C ity <br />✓�� <br />State/Zip <br />State/Zip <br />�� � � ������ <br />.� <br />Phone <br />Phone <br />� rJ � ! � r� '�'r , � e)'"" � -� �' <br />��/r1a^, �«�-�k-��. �,�,�,, � � J ��w>L��� �( ��� �,11'lt��"s`('> �,"`��i l'��� :T�-J��`;) <br />Electrical Contractor Mail Address City State/Zip Phone <br />��� � v� � �� <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />�.� �� � � D � <br />City of Everett Business License Number (required) <br />� � ' ��� L,:v <br />Kr <br />Contract Price of Work <br />��, �� �, (� ia�^ v �- <br />��,��,�`'r t • l;» `J C�: �'c'_v� l�E�t���,.��c�.��.C_ <br />Contact PersonlContact Number/Email , �� ,�,� <br />Description of Work to Be Done: �� �'��c�� �`-�' L��� � �.�1`�--L�`' l� �� li' ! i� ��'��' ���'nU �_ <br />-, � .i� <br />�-i-�' �c,��f� i <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerfify thaf I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whetherspecified herein ornot. The granting of a permit does not presume to give authority to <br />violate orcancel the provisions of any otherstate orlocal law regulating construction or the <br />performance of construction. That I am authorized by the owner of this properiy to perform the <br />v�ork fq r which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />L9�.2G� WAC. <br />D <br />REVISEO 08/06/2014 <br />FEE <br />�� � <br />PERMIT# <br />E C5�-�� <br />