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W �y � � ,` �`"� " � �'.'i � � F�� � �i� � �:`'� �' r w � ' �;" ,�� ��� c„�� � w �"' � �.� " �� � a.� �; � <br />�I�� �� ���R��� ������ �E�vl��� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�� �a � � 2 � ��- ,��� <br />� � � <br />PROJECT ADDRESS <br />ner <br />Mail Address <br />� <br />City <br />State/Zip <br />Phone <br />� oah� P' �I e�� �Fc�-e� Z� z� , � �- ,� ,.�,ne� u�J�- <br />Tenant Mail Address City State/Zip Phone <br />/ <br />Go��,,�,�--,� G>-, � � �,�1 v��� � �,- <br />Electrical Contractor Mail Address City State/Zip Phone <br />�� ���� �PL -� �c.- ��� �.:�3��. <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 />b a-�1�� ��'I <br />City of Everett Business License Number (required) <br />� Z��,c,�' <br />Contract Price of Work <br />,�� � I' , -7 <br />/ Y I ( �K �+st,�.� �f Z� S % � t7 � �`t ! <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: �a/ i�� c: �L v�.�j' (-� d � t�_ �� ✓� tM�.c � Li1.�.G�1`(�j (,�L�_ <br />��, rti��7 �",..vc.� (�'��� � �c � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this applicafion and know the same to be true and <br />correct. Al! 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 <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construc on. That I am authorized by the owner of this property to perform the <br />work for wl�ich applif �io is made and 1 cf� mply with the State Contractors Law 98.27 RCW and <br />296.200 W61C. // /% // i _ <br />ign <br />REVISED 08/06/2014 <br />FEE <br />�j, /'`� , <br />�j"� �—`�/� VC..� <br />•p� ►.� v � <br />� � <br />PERMIT# <br />E�I��D-(i��l <br />