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� <br />� <br />-� � � :�. :�, _� ;�� � s <br />�; <br />CfTY C�F EVERETT PERMIT SERVICE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8$57 — www.everettwa.org <br />�'�� ii-� �4-, � �C� <br />2�0�� 1 ���- � <br />PROJECT ADDRESS <br />-�--����— �� � � <br />Owner'' <br />Tenant <br />���o� <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />SfatelZip <br />'j 4 � <br />G�� �0� � �`� '��2� <br />Phone <br />Phone <br />i { �,� c" . , �/ <br />�{L.� <br />U��t�'r� l�Y��C � 3J� l�� ��� s C ���� �to��?� �1 G�,�� /��'� /���' � �� �� s`/� <br />Elecfrical Contractor Mail Address Cify State/Zip Phone <br />����i� � ��3'�J � <br />State License Number (required) <br />-�'=�>' ��;�'i - �i; ��;' <br />Proposed Use of Building � G <br />> <br />C� � �- �� �' � , � �iC� �� ��� � (� ��s�;¢�-. <br />Square Footage (If residenti 1 new cons ction, remodel or a ition) <br />Number of devices (If low voltage} <br />Descripfion of Work to Be Done: <br />�... C, u-� �i"c: lt-�` vl <br />c��� l �� <br />Cify of Everett Business License Number (required) <br />� � �� • ��� . <br />Contract Price of Work <br />���.� a�>���, �rZs -�� �� s5� � r <br />Contact Pers�n/Contact Number/Email <br />� � �;1, S�1v l� r'� � , ,l� f�/ <br />CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br />1 hereby cerfify fhat l have read and examined this applic� <br />correct. A!I provisions of laws and ordinances governing this type of work will be completed <br />whether specified f�erein or not. The granting of a permit does not presume to give authority to <br />violate or cance! the provisions of any other sfafe or loca! law regulating construction or the <br />performance of construction. That 1 am aufhorized by the owner of this propetty to perform the <br />work for which 'cation i�mapbe and ! comply with the State Contractors Law 18, 27 RCW and <br />296.20 .// �� . n <br />� <br />REVISED 08/06/2014 <br />� <br />P � <br />c? j,� �c`� � �` c�C� l <br />PERMIT# <br />E1���-��,� <br />, <br />