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_....__�_...._ _..._ ---__ _... _ ......... . .......... ..----_�� ._ .._ _ —_ <br />-----__r... _._ <br />_� . .___ .._.__.____— . <br />"" � �: • ,� ' �' � � * <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-251-8810 - FAX 425-257-8857 — www.everettwa.gav <br />�{2z t�rt� �!, �v��;G!t,, try��� ti�� L�, 3 <br />' PRUJECT ADDRESS <br />/� �'Vf� hr il�'Z �'7��k 1'��t L�YC_l'e��� 4J;t/ys`�'2e%}' ��"SG'l"'AS'�'_5,�" ' <br />t'�y?1,GGL.4. t'+� C. G it8_�.�.._ _. t _..� <br />� I Owner Niail Address � C�ty StatelZip pr��� <br />� tv it e t~ <br />Tenant <br />N1aii AddrEss <br />C�ty <br />State/Zip <br />Phone <br />`�ad7`�rr�t �s��s 327�' !'rx�ve S `�!.�0� ��,tfle t�.'.4-f �t�'J3y` t�G�C�-5'�•.5�-���c.� ��; <br />�lectrical Contractor rJail A��r�ss City State:Zip Pr�r�ne � <br />���i����f:�����'%{t ��.� ��. <br />' Sfate License Nifmber (requiredj City of Everett Business License Numher (requirec!} <br />� � 1 ���1°�� <br />' Propased Use of Buiiding Contract Price af W�rk <br />f' f/ i <br />�t'ci �7w��ti�G;f'_;'_�"J -�e:.3�`'��'t',%/t"pW� ��t�S 1 rrrrx�,��:! <br />� Square Foc�tage ((f residentia( new construction, remadel �r addition} Gontac�t PersonfContact NumbsrlEi��rail � , <br />I Number of devices (if low voltage) <br />Description af Work to Be Dr�ne: �^3'� �� �X, �� %t �� ,�'44 �yy.f}e� Prt roo-�, <br />CITY C7F EVERE7T Lt�CAi� SALES 7AX CQDE IS 3105 <br />! h�reby ce��t`fy thaf l have read a»d examrned thrs appJrc�tian and know ihe s�me ta be true �nd <br />r.r�rrect. ,�l1 provisians af laws and ardrnances governing this type of work will b� ca�rrpt�ted <br />whether specrPied her�in or r�ot. The gr�ntrng of a permrt does naf pres�lme tn givP audhvrity ta <br />vrolate �r cance! the prc�visrans of any nther state orlocal Iaw regcil�trng constrt�ctinn or fhe <br />performarjce of construction Tt7af I�n� authorized by the owner of this property to perform the <br />work tor which ap/�lication is made and ! comply with the State Gontractors Law 15.27 RCW and <br />?96.20Q Vt�A C <br />: G � _ , _; <br />gnature <br />��'�. t7E�i�SEf� riA.'C6,2:;7a <br />FEE � <br />� <br />��,�= _� <br />PERMIT� � <br />� ��►o - a��� <br />