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• <br />�w G �`"�^ ' � `�r ;� r'" ° �1: � �� ,�� vt '4� ,y� ��n ��o- d k `� ,� _�- �, Fin t:F � <br />CITY OF EiOERETT' PERMIT° SERO/ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�C � ��,J�C���� �` ��1� � <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />�vf <br />�r�`�-�?__ �)e�� <br />StatelZip <br />Phone <br />Phone <br />���ss��� �,kil �t� � �1 C �► ,�r� �-��i`f� �' �.�=, <�t� «�a. �=��:�1� ��5 � �-�3 � ( <br />� � <br />Electrical Contractor Mail Address City State/zip Phone <br />��'G � �� ,�f't�7 �C-� <br />State License Number (required) <br />.Pn, �-1 C' �1 ��i��, <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voitage) <br />Description of Work to Be Done: <br />Qj�� � ��, <br />City of Everett Business License Number (required) <br />� �� ��� <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br /><,.� �i (�;�;; ,� �v ( --� P1 �� �� �' �C.-, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I 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 />whefher specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any ofher sfate orlocal law regulating construction or the <br />pertormance of construction. That 1 am authorized by the owner of this properfy to perform the <br />work for which application is made and ! comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />REVISED 08/06/2014 <br />FEE <br />���, � <br />PERMIT# <br />E151�-�z� <br />