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<br />�1iY C�� E!l'E�ETi P�i2N!!i" S�RV'I���S
<br />3200 CEDAR STREET, EVERETT, WA 98201
<br />425-257-�81� - f=AX 425-257-8857 — vdww.everettv�a.gov
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<br />TPnant Mad Address C�ty StatelZip Phone
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<br />Electrical Contractor Mail Address City �ta:e2ip Phonr
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<br />State License Number (required)
<br />Proposed Use of E3uilding
<br />Squ���e Footage (If resiciential new const
<br />Nui�iber of devices (If low vollage)
<br />r�model or addition)
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<br />City of Ever�ett Business �icense Nurnb�r (requirecl)
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<br />Descri�tion of W ork to Be Done: � � ii `� l <> o ��, � , �.� � � � �� f�-, f! � �^ •� � �� �� � "i t� I �.-� C, c� � � c, .�� l � L i "� . —
<br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105
<br />! hereby certify that ! have read and examined thrs application 3nU know thc sarn� to be true ar,d
<br />corrc ct. A11 provisions of laws and ordrnar7r,es governrng this type of work will be completed
<br />whether s�ecifred 1�erern or nof. Tl�e y�anting of a permit does n�t presume to give authority to
<br />vrolate or cance/ the provisions of any other state or local law requ/ating construciion or the
<br />�.�erformance. of construction. That 1 am authorized by the owner of this propeity to perform the
<br />vvork (or whrch application is rnade and 1 r,on�iply wifh the State, Cnntr�ctors L��w 18.27 �,'CtN �nd
<br />296.20U WA C.
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