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<br />�(TY (�� �V��?ETT PERNIIT SERVIC�S
<br />3200 CEDAR STREET, EVERETT, WA 982Q1
<br />425-257-8810 - FAX 425-257-8857 — +.�.,� iv 3.� _ � �� ���..,�: ` �' �,�,� �,�� ,�'
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<br />ElectriCal Contracfor Mail Address Ciry State/Zip Phone
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<br />State License Number (required) City of Everett Business License Number (required)
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<br />Proposed Use of C�uiltling Contract Price of Work
<br />Square Footage
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<br />residential new construction, remadel or addition) Contact Person/Contact Number/Email
<br />Number of devices (If low voltage)
<br />D�scri�tion of Work ta f3e Uone: ��-•a�"�1�'lL C�^'� '-: �` 5�'�iU i ti �. j �''� :��-�yv�
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<br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105
<br />! hereby cert/fy that l have read and exarn;hed this applicatron and know th� same fo be true and
<br />correcf. All provisions of laws anc� ordrnances governrng this type of work will be completed
<br />whether specified herein or not. The granting of a permit does nof presume to grve authorrty to
<br />violate or cancel fhe provisions of any other state or local law regulating construction or fhe
<br />perforrnar�ce of construction. Thaf I arn authorized by the owner of Phis property to perform the
<br />work for which application is rnade and l comply with the State Contractors Law 18.27 RCW and
<br />296,200 WAC.
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<br />RtVISED 08/Ofi/2t774 � � ' L � --n� l,� �;�{,
<br />14/ �_,,,. �
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<br />PERMIT#
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