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425-252-1666 c.m.heating 15:58:33 11-23-2015 <br />L..`.�..v ����v � �.i��ri� � i--» i �.�v � �v�� <br />CITY OF ERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881 D- FAX 425-257-8857 — www.averettwa.org <br />, , � �/ <br />ROJECT ADDRESS <br />;mer <br />�nant <br />�..(n.���1 <br />:ctrical Contractor <br />�a� <br />tilaii Address <br />tiiail Address <br />Maff Address <br />�(�11�M Nr��7 br•] <br />3te License Number (raquired) <br />�pased Use of Building <br />uare Footage (If residential new construction, remodel or addition} <br />� <br />imber of devices (If low voltage) <br />:scription of Work to 8e Done: <br />TY OF EVEREiT LOCAL SALES TAX CODE lS 3105 <br />City <br />Clty <br />C ity <br />, <br />S�ate/Zip <br />State/Zip <br />�.01 Z�C <br />State2lp <br />� (Du J �'I J �o�� <br />__���� <br />Phone <br />Phone <br />� �a �p <br />Phone <br />O I (n 09 R <br />Cily of Ever�tf 6usiness Llcense Number (required) <br />�'o� �O �' <br />Contract Price of�1/or� �_�1'`=tJ <br />�31 i; /� <br />• - - - - 1-J % L, r . . . <br />Contact Person/Cantact �lumber/Email <br />� <br />ere6y cerUfy that 1 have read and examined tftis applicafion and know the same to be frue and <br />rrect. All provisions of la�vs and or�rnances goveming fhis type of �vork �vill be completed <br />iether speci�ed herain or nof. The granting of a permif does nol presume to glve authority to <br />�late orcancel fhe provisions nf any otherstafe orlocal law regulating construction orthe <br />�rformance of construction. That 1 am authorized by the owner of this property to perform fhe <br />�rk for which applicaiion is made and 1 comply with the Sfafe Conlractors L.aw 18.27 RCW and <br />�6.200 WAC. <br />ws�D o�.va2o�a <br />FEE <br />� �� <br />PERMIT# <br />E ����-��� . <br />2 /2 <br />