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� <br />� <br />,d � ... , _ , ..�. 4 . <br />� � � �, � � �. r � : .t . , <br />CITY OF EVERETT PERMIT SEI�VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />/C_'G"C� ,�/ / ��.r,� /�.���i��c'_ <br />PROJECT ADDRESS <br />/��:� -; f�%'�, ir� fc� . �, /c:'f �, �;/ ; ?;-,� /�.,_ � � . ��<„ic-/— C�/f �i�"��.; <br />Ownef Mail Address City State/Zip Phone <br />`/� �r ��-1 ,l <br />Tenant <br />Mail Address <br />�7, -� r �2 ) <br />�i ✓,L >:.: /��'�,�,. j ��.���r%7�• C- �;.�< : `-- �� <br />Electrical Contractor Mail Address <br />J <br />� .� �'�-� j=- �=" �� ?,�-r <br />State License Number <br />/1��J�,���;,� N' <br />Proposed Use of Building <br />City <br />`/ `f ;��'.�'/ -�.� /�� G�/ <br />Citv <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />State/Zip <br />`-1 l � - <br />State/Zip <br />Contract Price of Worl< <br />Phone <br />� G' �'� <br />y�s���;�/ <br />Phone <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �j: � �.-� � ���� /��•�<� l�%-, ��,��-.-..�1, � ��- /�%, �<=,-,-, /_ <br />-� r'� '. , ,,�• , l �, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby certi(y that l have read and examined this application and know the same fo be true and <br />correct. All provisions oflaws and ordinances governing fhis fype of work will be completed <br />whether specified herein or nof. The granting of a permit does not presume to give authorify to <br />violate or cancel fhe provisions of any ofher state or loca/ law regulating construction or ihe <br />performance of construction. Tl�at 1 am aufhorized by fhe owner of fhis properfy to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />,� " }�/� �) = .-� <br />� � I / ' �%�? L. :h�,-i.--1 lJ Gi �� ' <br />ature � Date <br />FEE <br />�� � �� <br />PERMIT# <br />E � � �� -- / � / <br />