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� �: v `�a < �� � �� :�: : � <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 />zs�,� ` j�' ST' `�� �(8�-�3 <br />PROJECT ADDRESS <br />�LV t s � J�(1�1�; R- � �.e% <br />Ownef Mail Address City State/Zip Phone <br />F �. <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />� �� ��r..��t,�n L `f � c-3- .� �esm3 � ��-� 1r�4, `�11� d r�- P '� � - `(� � `"5 � � <br />Electrical Contractor Mail Address City State/Zip Phone <br />-���-� P �� �.�-s <br />State License Number (required) <br />�� <br />Proposed Use of Building <br />��A <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City of Everett Business License Number (required) <br />� '�7 d �. '.. <br />Contract Price of Work <br />E A-�sz,r--�1 �--�--�� <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: (��-ST'nc�-3-- �c I�-ts+� i"�' �� �� a <br />t�, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�"� <br />1 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 governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority fo <br />violate or cancel the provisions of any other state or local !aw regulating construction or the <br />performance of construction. That 1 am authorized by fhe 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 />REVISED 08/06/2014 <br />FEE <br />r� <br />�� % <br />PERMIT# <br />E c�c7-��� <br />