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s � � � � � � � i <br />CITY C3F EVERETT PERMIT �ERVICES <br />3200 CEi�AR STREET, EVEF2ETT, WA 9$201 <br />425-257-881 Q- FAX 42v-2v7-8857 — wwav.everetfwa.gov <br />;�0? �� ���,�ErT HqGc. wA� �V,EQE i�' wA 9g2o � <br />PROJECT ADDRESS <br />QAL�w�n,/ (�QvTHE,r25 /CX�7S �! GUv, wA;' NAy�c�,Cti/ 1D 83�,�5 2�+6�• 2`7- 98Y5 <br />Owne� Mail Address City State/Zip Phone <br />:�R 4�' `� tvo7 sF �v�aErt��t..� wA Y �v��¢Er-� �,�,� q�Zv 8 �2� - 3�f7-867� <br />TenBnt M1Aail Address City State/Zip Ptione <br />�-1DUAtJ��'.t� �1�,�.l5 �1..� 1 3'?T�' �r Nw �uc �4vQ�ar.� �„�J'�a q�3aa� Z.i3-98?-5� <br />EieCtrical Contractor Maii Address City State/2ip Phone <br />�� vA�J 6 L� R Z�,a t� <br />Sfa#e License Number (required) <br />�vw+M��LG ►�L. <br />Proposed Use af Buiiding <br />N l� <br />Square Footage (if residential new construction, remodel or addition) <br />3 <br />Number of devices (If low voltage) <br />O �' 3gC> r <br />City of Everett Business License Number (required) <br />�s Sv. c.+ <br />Contract Price of Work <br />,/ fi 5a.a r n�1 �v �2 <br />ZS3-`l�?-S�U�t fi5�•Ti4��u.2,.JC�G�'?A«.Gvt'( <br />Contact Person/Contact NumberlEmail <br />Description of Workto Be Done: '�v�-+Nc�7- 2 w�+�� SIL��.IS iU �X/Sr'"/I�IG SiGtil �v,acv� r` <br />- Cc> �.ln,1 E G 1- ��•�E � SiAI-J,r�ir.,,/ � S i G�✓ I t� � X i S T��1 G�� 4 �,l <br />G � �Z�.� � ; <br />F�E <br />CIiY C}F �V�RETT LtaCAL SALES TAX CQRE IS 3905 ��� <br />1 here6y certify that ! have read and examined thrs application and knos�v the same ta be true and <br />correct. All provrsions of laws and ordinances governing this type of wvork �vi1l be complefed <br />whether specified herein ar not. The graniing of a permit does not presume to give authority to PERMIT# <br />vrolate or cancel the provisions of any other state or local latv reguiafing construction or the �� �- �� J j, i� <br />performance of construction. That I am authorrzed by the o�vner of fhis property to perform the � l-� <br />�vork for whrch application rs made and 1 comply with the State Cont�actors Law 18.27 RCW and <br />29&.200 WAC. <br />�. i�'L�f�b� �v�! T�c7- �/ASvN i �y�vr� 253 -`td7-s�?v�j �/1 �- <br />REVISED08,Ofi201a PAI� %�l.-�'� <br />