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C� <br />�. ��� �,... � �. ..� ` „ ,� ,� � , �,.� , � , �, � � � , �; � µ.. F <br />,� �, � <br />CITY OF EVERET'i PERMIi SEF�VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />��U 2 �A %7✓11(.LL_� /�1/ � <br />PROJECT ADDRESS <br />�Z� <br />P�'��� ��1 �� �,.�� � ZZoz w��rn�►� �g ���� � 7 r�/� ��,2� o�i3 -sy is <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Ol/� �t � <br />Electrical Contractor <br />State License Number (required) <br />�.� ��,�, C �� � 1 <br />Proposed U e of Building <br />Mail Address <br />Mail Address <br />1(OOv <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />I <br />Description of Work to Be Done: �K}'►'!c�/rt'� ��d�� � <br />O�b 1 �f �t�-�i�.� e��� ( ��,2�. � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />C ity <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />s <br />C�,c)�l lS� <br />Contact Person/Contact Number/Email <br />I hereby certify that ! have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authorify to <br />violate orcancel the provisions of any otherstate orlocal law regulating construction orthe <br />performance of construction. That I am aufhorized by the owner of this property to perform the <br />work for which applicafiqt�-is�nade and I comply with the State Contractors Law 18.27 RCW and <br />296.200 VY�1 C. (��� <br />re <br />REVISED 08/06/2014 <br />FEE <br />� � o0 <br />� <br />PERMIT# <br />Ei���-I�� <br />