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EL CT 1 :,A L PERMIT A PLICAT I ►N <br /> CITY OF EVE ETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-267-8810 - FAX 425-257-8857— t.✓tti ttJ-e(e4i,e. wex.• <br /> e kte..; I; .Zvrt rrt44.e p 5 g tJz,r' Wet;- £ V <br /> PROJECT ADDRESS <br /> Owner Mall Address City State/Zip Phone <br /> Grti4iNi)VteV) 641'1,5. <br /> Tenant Mall Address <br /> X a City State/Zip Phone <br /> I v ODItLikek. EL :qv-IC,. (b t)o.ir ) t i LANJD L+..Jq, 9 iJp v37,5 l �''9 `L •20 ! <br /> Electrical Contractor <br /> Mail Address City State/Zip Phone <br /> 1N-ObALE 3 - 0c1 VI d? v(7.1 <br /> State License Number(required) City of Everett Business License Number(required) <br /> • 6PAItAltWts Ai u �`rs i q-wiL 4. 1 '0 <br /> Proposed Use of Building Contract Price of Work <br /> I t�.'�'lAl f h.) Logu.,4r44 <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; COSflA1iS14V i 4 4,,rfAconeiovt (..,t6141-s; <br /> $.& reA ) ri{A Ge jtht DS l G/Zt.a t r-S <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ,S �d <br /> I hereby certify that l 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 I am authorized by the owner of this property to perform the E IS(( - 0 7 2-- <br /> work for which application Is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> rk-11,144 <br /> Signature I <br /> tJ Date <br /> REVISEDOiV08/T014 LL 7 6.--1-1-A • <br />