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� <br />� �, '% i� �, ■ i= � ! 1 p �� <br />CITY OF EVERETT PERMIT SERVICE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />2 � /� ��t��;,P <br />PROJECT ADDRESS <br />�n���� r� l�r�� i 1! i)� ��-� �%0 I,� �<< %�P GNft C/���� 2����32-77-�is <br />Ownef Mail Address City State/Zip Phone <br />Tenant <br />Electrical Contractor <br />State License Number <br />p�/�t ,�l �lu. ,���,�, �� / <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />City <br />State/Zip <br />State/Zip <br />Contract Price of Wor{< <br />Contact Person (Plan Review) <br />Description of Work to Be Done: r� �- C'G/J ,��r; �'r ���� r��T' ��� �����c <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined ihis applicafion and know ihe same to be frue and <br />correct. All provisions of laws and ordinances governing fhis type of work wil! be completed <br />wheiher specified he�ein or not. The granfing of a permit does not presume to give authority fo <br />violate or cancel fhe provisions of any ofher sfate orlocal law regulating construction or fhe <br />performance of construction. That I am authorized by the owner of fhis property to perform ihe <br />work for which applicatron is made and 1 comply with tl�e State Confractors Law 18.27 RCW and <br />296.200 WAC. <br />j��- � y=�v-�`f <br />Signature Date <br />Phone <br />Phone <br />FEE <br />�� �� <br />PERMIT# <br />E ;,� 1 �f� � - ��� <br />