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ry.._ ,.,� .--:. ,� � s r�•� r� �. r� M c �=fr ... P� •�e, 3 r r^'� :. ., <br />CIiY OF EVERETT PERMIi SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�':��% ,-S� {. � �� r�� <br />PROJECT ADDRESS <br />("�..Zs��'� i 113; <br />uV`li'�! S CLi. , r` v� �LK �,- �. jS"1! lS_tl�r�G� �%. �S�.cr�cl►l� ,�tii � i�IS`� <br />Owner Mail Address City State/Zip Phone <br />%` %1 ����1� S � � �� i� ! � �l(.���1 �il t'i � � � � <br />Tenant Mail Address City State/Zip Phone <br />��`�'�1�� <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number (required) <br />l ��'ZC,-G�. <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: <br />� <br />,� ,_ <br />(,v' L'`%�I.G� C�: X'6 j ' �,iZc <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City of Everett Business License Number (required) <br />(�',% Cy , <br />� �� <br />Contract Price of Work <br />jv(��' il :�e-(l' l�° � , <br />Contact Pers n/Contact Number/E il <br />I hereby certify that I 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 will 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 other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform fhe <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />REVISED 08/06/2014 <br />%�Lj-- j�_ <br />1 6� C, l, i-�.1 S-�e � <br />FEE <br />� <br />PERMIT# <br />E � � ��I' 2� <br />