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• • - <br />� � _ �� ��� �� <br />CI`�Y OF EVERE�`� P�RNII`T ��I�VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />^����� �������:� <br />PROJECT ADDRESS <br />�� �� � �� �� �. <br />Owner Mail Address <br />� <br />!' :� �:;� � U Mt .� �., r� ��: <br />Tenant Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />.--., -� a <br />� , °°�1'11'�.� r ;- � . � �. <br />��U: F"-�-�i..�.�- � �;; t� �, ri,..� � i� � . ���� �cr�����L� �,,T; ; �-� �; t' `"i <br />Electrical Contractor Mail Address City State/Zip <br />�..t • <br />����-ti: �'�'�`� �'`'��; �t... <br />State License Number (required) <br />� � v�:. ;,,_ � :'t ... :� � <br />,, �, <br />roposed 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:�� �`""4��" �- � r <br />�i ���i�,e'>al �'. t 1 A� << :� �' f t 'i t, f' (�,„, <br />CITY OF EVERETT LOCAL SALES TAX CODE 1S 3105 <br />� `� � � � :, n..� '. <br />Phone <br />Phone <br />Phone <br />C.����i� <br />City of Everett Business License Number (required) <br />�� � � � �,�;i �,ts <br />Contract Price of Work <br />�, <br />-.- <br />�r�vE�.. `�.� ��G� �, a � <br />Contact Person�/C.�,,ontact Number/Email . F <br />.. . ..-. �t j_ 4� �� � �' f � i�` 0�. �i:d�,,� �- (. g � �'" ,� (!' i l,- . `.� -� <br />�. i.'y <br />��� �t,. , � FrA.a: � �,,� �-�,a <br />I hereby certify thaf I have read and examined this application and know the same to be true and <br />correct. AlI provisions of laws and ordinances goveming 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 otherstate orlocal law regulating construction or the <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 I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />4,. _ _.�, �: �..� .- �,..�,.,,,, ,. <br />'""' Signature <br />REVISED 08/06/20i4 <br />�a <br />t � '•. j i � <br />FEE <br />��;�� l � J✓ <br />✓ <br />PERMIT# <br />E������v�I <br />