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� <br />E�.ECTRI�AL P�Rilllli ,i4,P�'L�CAiaON <br />CITY OF EVER�`Ci' PERMIT ���VrC�S <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />426-�57-8310 � FAX 425-257-8857 - www.ev�retfwa.org <br />� � d `� ��-d.�-�-�,� ��V � <br />AROJECT A[?DR�5S � <br />C� ��-��f �r�a=b-�r� `�,� Z-- ��'�a � � '�V� � � �. �� � `�, � � - <br />Owrter lVlail Arldress CIty Sfate/Zlp Phone <br />�� <br />7enant <br />Maii Address <br />City <br />Sfafe/Zip <br />Phone <br />�� �"�—��. Cc� P� i�✓ ��,�� `F�, c��-c- � 1�.� � � 8 a �k I � � ��� ' �l.l.$ <br />Efectricaf Contractar Mail Address Ciiy statelZip P.hone <br />[-��s � l� C� �'� � �'�" <br />State License Number (required) <br />��`�Z <br />Proposed Use of �uilding <br />�1� � <br />Square Footage (If residentEal new construction, remode] ar addition) <br />IVumber of davices (If !ow voftage <br />� �.S Z. � <br />City of Everef# 6usiness �icense Numbor (requiredj <br />� ��✓ � <br />Contract 1'�ice of W�rk <br />�� ��.� <br />Confact PersonlContact Number/Email <br />�-�-�-- ��s ; �lL� <br />Description of Work to Be Donv: t'�,�'i"��-k— ��-�iT �� ��'r �v V�-� � <br />✓Yl '� r..�►�i�1,�%C. c i�.�"c� _ <br />CIiY OF EVERETT I�OCAL SAL�S TAX COA� IS 3'I05 <br />1 hereby certify thet 1 have read and examined thfs appllcation and know ff�e same to be true and <br />co�rect, A!I prov/slons oflaws and ordinances qoveming this fype of wor!< wl(1 be completecl <br />whefher specrfled flerein or nat. The grantirrg of a psrmit does nof �resume fo qiv� authvrity fo <br />vfolate oi• canc$! the provisioRs of eny other sfate or local !aw re�ulating consfruction or the <br />perl`ormance of construcfJon_ That I am aufhorized by fhe owner of fhis properiy fo perform the <br />Wo�k f�r which applicaf�orl Is made and ! comply wlfh thg 5fate Contractors L.aw 18.27 RCW and <br />296200 WAC. <br />�B <br />R�VISED 08R76/2018 <br />L � � �� �l-sy <br />F�� <br />��o� <br />��RMrr# <br />E � � t � - 2�-� <br />