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01/15/201� 09:37 3604740126 DONNELSON ELECTRIC INC #3762 P. OD1 /OG1 <br /> � <br /> E�,.���`����� P�I�MIT` l������,A►,���� ; <br /> � c��x �� �or���r� ���r��-� s��v���s � <br /> i 3200 CEDAR ST€2EET, EVERE s T, WA 98201 <br /> � 425-257-88'f 0 - FAX 425-257-3857—wvvw.everettwa.gov <br /> � <br /> ' <br /> i � � .. , <br /> � � �� ��� �' � � ' �n� �� ; <br /> I T- I <br /> �(ROJECT ADDR�SS <br /> E I <br /> � � f�,- ������ns� f s� <br /> i Ownef Mai!Acidre� City State/Zip Pt�one I <br /> I ' <br /> I <br /> � Tena�tt Mdil Address CiYy 5fate2ip Phone <br /> �i I <br /> �� �i sa� ; �►�; .� ��Z -�s-��, E <br /> Electrica[Contr��or Mail Address ity Sta;e/Zip Phone � <br /> ' �fli O -.O� l � <br /> State�;cense P�umbe�r(required) City of Everett 8usiness License�lumber(required) <br /> ��� <br /> Pro��sed Use of 6uifciing Contract�r€ce of WorEc <br /> � ,��a�3 �tr�7E� I <br /> c-i?��- � - �/�8 ' <br /> Square Footage (If residential new construction, remodel or addi#ion) ContacY Pesson/Contact t�umber/Emai1 I <br /> � I <br /> � <br /> i <br /> Nur�ber o�devices (lf Iow voftage) � <br /> I <br /> � Descriptior.of Work to Be Done: �� 7 ���, z� �, ���.t ��y��� � <br /> � � <br /> I � <br /> i <br /> ' . I <br /> I <br /> ��E C <br /> � Ct'6'Y OF EVERE-iT LOCAL Se4l.ES TAX CODc 15 3705 � � ' <br /> � I hereby cer�ify that I have read�nd examined thrs application and know t�ie sarrre to b�trcie and � ` / <br /> � co�rect. q/I provisions of laws and or�linaraces goverrring fhis fype af Nork will be cornplefed <br /> � whether specified herern or not The granting of a permrP�oes not presvme to give authoriry to PERMIT# � <br /> violate or cancel the provisions of any other state ar focal law regulating constructiorr or th� � � <br /> performance of const�uction. That l am autharized by rhe owner ef t?�rs properiy to perform the E i� O l� 1� <br /> � work for which applicafion rs mad�and I cam,�ly wrfh the State Contractors Law �8.27 RCW and � 4 i <br /> j 296.200 Wi4C. 4 <br /> I I <br /> ' f l7 I � ; <br /> Iate <br /> � i <br /> REVISED 03Po6/201a � <br />