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�: � � � �. �- .�: , �. , • ; <br />CfTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />2 � <br />' J t �� � ��� � �-c :�.� <br />PROJECT ADDRESS <br />C_ � v��J�l, �"��.� <br />Owner <br />Tenant <br />j' l.c'�-�s� �� i - �1�-� <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />��v ;� l ��� <br />Mail Address <br />��b� t�idi `j' �: l C� `2..� ���� <br />State License Number (required) <br />5���-� . <br />Proposed Use of Building <br />���� �� �1 <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: � <br />j o� ,� ��'+c��{ ��� <br />� � � �t`� ��J�1 <br />City <br />C ity <br />L�✓�c;�:�� <br />City <br />State/Zip <br />State/Zip <br />e�2,;-_�� ..�� � <br />Phone <br />Phone <br />`=1 �,��� u ��5-_-�?S�-t:�Z <br />State/Zip <br />Phone <br />City of Everett Business License Number (required) <br />`'.) / Y �� c� <br />Contract Price of Work <br />_��J c=�-�' _ 2c>4 -`C'3 c�� - t S`� S <br />) �..�-C�v'vt+��.z�S; l�i:��- c_.�Zc�Z.�2 K' C � <br />Contact Person/Contact Number/Emai) <br />) �_� d�ti� ��1�� ��-�� t �--� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�: �(�.���1,'L: ��'�--- <br />1 hereby certify ihat l have read and examined this application and know the same to be frue and <br />correct. All provisions of laws and ordinances governing fhis fype of work will be complefed <br />whefher specified herein or not. The granting of a permif does not presume to give authority to <br />violate or cancel the provisions of any other state or local !aw regulating construcfion or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />worlc for w'ch application is made and I comply with fhe Sfate Contractors Law 18.27 RCW and <br />296.200 �C. <br />; <br />t� <br />REVISED 08/O6/2014 <br />�v��`t � � 5: <br />n <br />C,j � �� 1���-'�� <br />�'_���c � x-' �Z.`�c� <br />FEE <br />�� o� <br />PERMIT# <br />E lSID- (�I <br />