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;� � ,� :� � ;�: �� :�; L. <br />�> <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� a� 9' � 7 �� �v�_- �� <br />PROJECT ADDRESS <br />�u- � ► �% � � rJeS, <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />Sf'-��E'(� ��CGTr'C-�l� �f✓v<i.ils ��/�I/V Gc.l��'ttil�✓ �(} J��G'rr.�� ��" j� �/�s �39�7' `%G1,�� <br />Elecfrical Contractor Mail Address Cify State/Zip Phone <br />�"�c-�cEs ���k." 1� <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: P��^ �o �j �S �v � lJ �'1 C� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />C�.��l�y� <br />Cify of Everett Business License Number (required) <br />� � �3�<� <br />Contracf Price of Work <br />Contact Person/Contact Number/Email <br />l hereby certify that l have read and examined this application and know the same to be true and <br />correct. A!I provisions of (aws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume fo give authority to <br />violate or cancel the provisions of any other state or /oca/ !aw regulating construcfion or fhe <br />performance of construction. That 1 am aufhorized by the owner of this property to perform the <br />work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />O/�� <br />nature <br />RE'VISED 08/06/2014 <br />FEE <br />d'� <br />5v � <br />PERMIT# <br />E ���D—o�5 <br />