Laserfiche WebLink
0 <br /> PI c:rilkiCAL RM9 T APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREJ [-, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857— w/t.v(.6)-e+'ire.-* -ww.•jd / <br /> AAA,' I'. .e viz.re4-4..eIpS & 6 tier-al WeLidV <br /> PROJECT ADDRESS <br /> Owner Mall Address <br /> City State/Zip Phone <br /> V ' <br /> Tenant � _��, Mall Address City . <br /> ` 1 State/Zip Phone <br /> 61 VI1 +,���,D 1. . 1 ((•''Di1s (Li 10tz 2c I-6, <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> P.c b t,E 7 -30(6 0 C.,"2,-- 1 `I <br /> State License Number(required) City of Everett Business License Number(required) <br /> f�P e '; <br /> a -n1,Lt7i rrs 4C <br /> Proposed Use of Building Contract Price of Work <br /> .T- elms,rJ 'Fwd.``Y1/4.olj.;LiAr 12 i1lw LirvU,lc'4,\ <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: C,C-Sh�c 1`1Gl CM: ;1,`7 5isv i N(0 16--t<'(,,:\64:yy ov„i_ C1 t..,t6H-r-s; <br /> ) <br /> `LAT1.* 1---'(\pc; ) IZ/A I0l vt,vL)S y 4. /, ,, <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5& 09, <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That l am authorized by the owner of this property to perform the E I D4. I13 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and ` J <br /> 296.200 WAC. <br /> rar <br /> .l\ � ",ti- ;' 0 a5 07° 6 <br /> Signature ! ) D.te <br /> Pevrsev 011.V02014 3 II C L c.t'`t`li . <br />