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,�ra ,� �, ,� : e � � �c '� . ��, � � � .� � F .� �r, � <br />CITY OF EVEREiT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />��D Z- �,u>�' T/n �� At�'�� <br />PROJECT ADDRESS <br />G/ Z`� - <br />S L� c ht�. 5 G..� �,� ��- +�v n� �2� ��,M r:✓'`. /�1i'c= /z v�-�r-aT [„9�. ��i [? l Z'� y'- 3%�� <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />C ity <br />StatelZip <br />Phone <br />_3�,�; - <br />"�1t��i�:c,� it�N�y'� �L� �! 3Z -�'1',J��i � �� �J��'�'�15�%'�e 1.��_ 9.��7c� �S� --��%�c7 <br />Electrical Contractor Mail Address City State/Zip Phone <br />r�a;�, ��.� y �� �, <br />State License Number (required) <br />Proposed Use of Buiiding <br />Square Footage (if residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: � p� %f �Gn i ��-+'�'?� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�G� z �e <br />City of Everett Business License Number (required) <br />3m G <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating consfruction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and l comply with the State Contractors Law 98.27 RCW and <br />296.200 WAC. <br />// <br />Date <br />REVISED 08/06/20>4 <br />FEE � <br />� � ��"" <br />�� <br />PERMIT# <br />E ��L� � ` � �� <br />