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425-252-1666 CM HEATING 02:14:41 p.m. 06-11-2015 3/3 <br /> LE T 3CpER�Vi1T. A:PPL[CATION <br /> CITY .F EVERETT::E1"4 :SERVICES <br /> 32. ...FEVER <br /> 0 CEDAR STREET; EVERETT, WA 982.01 <br /> 425-257-8810 FAX 425 257-8857—WWW everettwaorg <br /> 451* <br /> PROJECT ADDRESS <br /> r may" ✓ q25 2-S-Z 911( <br /> Owner t Mail Address <br /> City. Stateop Phone <br /> Tenant <br /> Mail Address City Sta(e/7tp Phone <br /> Cfyl Ie�-hnu`I <br /> Electrical Contractor' . Mail Addres§ City StatetZlp Phone <br /> O 1 Co Dq <br /> Stale license Number(required) City of Evetett Business License Number(required) <br /> Proposed Use of Building Cohtract Price of Work <br /> 1 Lf 252 qL <br /> Square'Footage(If resldential new construction,remodel of addition) Contact Person/Contact Number/Email <br /> Number of devices (If low Voltage) <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105. <br /> l hereby cerflfy that I have read and examined this appiicatton and knoW the same to be true and <br /> correct. All provlslons of laws and ordinances governing this type of work will be completed <br /> whelherspectfied herein ornot. The granting ofa permit does not presume to give authority to pERMI i# <br /> violate or cannel the pro isions of any otherstate oriocal14W ragulatirrg construction or the <br /> performance of construction. That l am authoKzed by the awn@r of thls propefly to perform,f he E � -- <br /> PP <br /> work for which a lication Is made and/comply w�tti the State Contractors Law 18.27 RCW and <br /> 296.200 W�qc. <br /> ':Signature LpDate <br /> REVISED 0"0014 <br />