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"` [ f°� ,'� � � � � � � � � '� � P� r r`� i� t .. � <br />— � . � . � . � _ � _ <br />r4� � <br />� , � � , ,: ��l t �s` <br />CI�Y OF EVER��°`� �ER9VIIT ��R\/ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� 6 � ���-'V l �ti S � v � <br />PROJECT ADDRESS <br />�a�1 � ��C�r�.� ����� <br />Owner <br />Mail Address <br />City <br />State/Zip <br />� S�� � <br />y�s� � ��,. <br />Phone <br />����� <br />Tenant Mail Address City State/Zip Phone <br />l�� � �/�-5�� 3�Z�_ <br />I � A.� � � E ��« s� �-3 � l�/� � r I. `� �o� w� �5�� � 5�3 � � <br />Electrical Contractor Mail Address <br />Q �� � <br />te License Number {required) <br />��� <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� <br />City <br />State/Zip <br />Phone <br />���D�� <br />City of Everett Business License Number (required) <br />l�� � <br />Contract Price of Wor <br />� ��� �� <br />��y����� <br />ontact Person/Contact Num er/Email <br />l hereby certify that ! have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a permrt does nof presume to give authority to <br />violate orcancel the provisions of any otherstate orlocal law regulating construction orthe <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />worfc for which application is made and l comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. � / <br />/ �� <br />REVISED 08/O6/2014 <br />FEE <br />� � � ��� <br />C.� � <br />PERMIT# <br />E I�G�I -�;t� <br />