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�. . 's ��... �°-" � �!3 I' ��'° f�:, � l+�r i M�� � k'; � �s a�y ��� p� re 4 �"�°` ��w `� P ��� w E <br />Y , . . _ _, _ ,-. <br />-. � � � ` � � <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� <br />(/�i <br />� yn ' .� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />i���_f���� �`s ,`_i ��?� 8� rno� �2�. gnhN�ry��i�'[.�J4 •��4� �a�o��) �� <br />ElectriCal Contractor Mail Address City State/Zip Phone <br />r <br />State License Number (required) <br />r�,-�-� 0 <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voitage) <br />City of Everett Business License Number (required) <br />a , s—oo , o a <br />Contract Price of Work <br />�������� �Zad-n �-ia���� o38S� <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: I?.., c�� r��� �`� L� `— �,� —� 1 S[ 031 ll�G'�S �U Cl.�' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 />whetherspecified herein ornot. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or loca/ law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property fo perform the <br />work for which application is made and I comply with the Stafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />REVISED 08/O6/2014 <br />FEE <br />l��-�o <br />PERMIT# <br />E l�0 t - ��—d <br />