Laserfiche WebLink
� ,� �; � � � � � � : <br />GI�'Y �F E�/ERETT PERN6IT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�� t� � f� c�: c�.t ��� e�' �� V�.. <br />PROJECT ADDRESS <br />Owner <br />1. .,:x��� .}'.R.,�',. <br />Mail Address <br />City <br />StatelZip <br />Phone <br />�, ,�-- �t�� a �= <br />�- �� i�= c� `� 1,1� � �!°� t�i?f`.A 4A r �t � � `;d-- t � "' ��'` �� �- o� � �r v � ` �'�ca�e' <br />c . . ,� n�, <br />Tenant Mail Address City State/Zip Phone <br />�t"�.� A!'7"� !'� �"�-e'C.°�.c�S=C ,�i�C. 1,3�''�.� ���"reg� f�� �.�'�`�..1 '�� ����o� �n�' P�,� ��-B:��e"�� <br />Electrical Contractor Mail Address City State/Zip Phone <br />��� l�� l �-� � �f � � � <br />State License Number (required) <br />�P r <br />y. � ���'�: <br />T �` <br />D."�NOse� L�se of Bui!ding <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (if low voltage) ' <br />�, �,1p.�.d�.:Q� <br />�. � <br />�::� �� <br />City of Everett Business License Number (required) <br />�,. � <br />a , : ,. ,� ' <br />Contract Price of Work <br />�� <br />� �� �� , 3 � g 4:0 <br />Contact Person/Contact Number/Email <br />�` .1' 3' ,b �" .` e^�, + � • : <br />� , , . <br />Description of Workto Be Done: li(%r t"�. �-��-'�� ��T E�-.�QF P,,,,j'"'" <br />CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br />I hereby certify fhat 1 have read and examined this applicatron and know the same to be true and <br />correct. A!1 provisions of laws and ordinances governing fhis type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume io give authorify to <br />violate or cancel the provisions of any other state or /ocal law regulating construcfion or the <br />performance of construction. That ! am authorized by the owner of this property to perform fhe <br />work for which application is made and 1 comply witl� the State Contractors Law 18.27 RCW and <br />296.200 WAC. , <br />� � �',¢q, <br />REVISED 08/O6/2014 <br />} �� . v Fr ;^ <br />FEE , <br />�1�.2d�� <br />PERMIT# <br />-�, � � �� �,Q <br />E '�� ���� (� ( n <br />