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_--. � r.� ,:^�,:,, mm� �=. ^ :� .� R � � � y .�°'.�°' . 1'� �.: N � .� ,. '°4k"` A . .`�, E <br />i <br />CIiY OF EVERET'T PERMIT' SEI�ViCE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />2a 9 cA, c�-s�,�o ,�a�v Su.,; ��s <br />PROJECT ADDRESS <br />��Nv 3�� � f� �'3 �'o s� �{3 eo �- �jc��2� �+2 .Z�, r�,4 �'f a �/v <br />Owner Mail Address City State/Zip Phone <br />l�1 �/'f'r l` <br />Tenant <br />V1�CNA�v�c�L � <br />Mail Address <br />�/c�S <br />Electrical Contractor Mail Address <br />C ity <br />State/Zip <br />Phone <br />��2 � �8-THSi L� ,iFLS �/�. ���/� �l <br />C zS'3-92�-97�'1 <br />�vt�-�-�ACS g � �c� _ <br />�ate License Number (required) <br />►'y►,X� us� <br />Proposed Use of Buiiding <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: ��(.SCOnlNE�1 <br />C ity <br />State/Zip <br />Phone <br />Q �fS9 �2 <br />City of Everett Business License Number (required) <br />�� �� �; <br />Contract Price of Work <br />2 s3-ZsS 388 � <br />.�SaEL sGKuPpa�Yz-� 5v��s c�GQc�,pn�c <br />Contact Person/Contact Number/Email <br />� �-CT �I ) ZO R/Z <br />� �� <br />DiSCo���` /-�,�D G�ti� P �SSoCiff r� W �Tf/ .�.��r�G���'NT <br />�oo�P �(�i�C � (�(�// T <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � L� <br />I hereby certify that l have read and examined this application and know the same to be true and �� J <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whetherspecified herein ornot. The granting of a permit does not presume to give authority to PERMIT# <br />violafe orcancel the provisions of any otherstate orlocallaw regulating construction orthe ? <br />performance of construction. That I am authorized by the owner of this property to perform the E(�� �� %� �;� � <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296�A C. <br />ature <br />REVISED 08/06/2014 <br />�7-"7--24(S� <br />uate <br />ca � <br />