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� -- r � ,� �s �. ` "� ,� � � k"' � � � `� f� � ��- � r !`� �; �l'� P �i �� � <br />€ - <br />! � F ti_ � �t c .a � 6 � �� �, <br />� Zv� <br />PROJECT ADDRESS <br />CITY OF EVE�E`�`� P�RMI�' ��RVICE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� <br />���- � G' `�) - J �J ��j /�✓� •��L�. � (,I =��;;"T e2�/', �f� Z�t� l <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />�jZ� ��� <br />`� �S-iL�u �l � � �' �- � /3 L 9 ��'�%,ti�� ri�'>,�NNs ��' �� �-J/�: �;':� � 7c' � �i "7� <br />Electrical Contractor Mail Address City State/Zip Phone <br />���s,-��������<� <br />State License Number (required) <br />Proposed Use of Buiiding <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />�� � z �� <br />City of Everett Business License Number (required) <br />�-�-- <br />3 j �� — <br />Contract Price of Work <br />� <br />�, ; -�;-c- t� � �� . �-�` T S-� / > ""r' i 7i <br />Contact Person/Contact Number/Email <br />Description ofWorkto Be Done: /��%JC�-�.:� �-�C"lS� '�4.r ��-�- �fc'« �--�3� %�=��C v��Hc ���� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certify that l 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 wil! be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any otherstate orlocal law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />re <br />REVISED OB/06/2014 <br />FEE <br />�� � <br />�'�'� : <br />PERMIT# <br />E l ���1' � ��� <br />