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� ,� � , � n .� : e � �°- � �. « �- ,,� !� a�t � � ,+-� ':: " � �: � <br />_ - i <br />CIiY OF EVEREiT PERMIi' SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�,� (I �aTK S�, �'v�`n.0 � ,%/r} . <br />PROJECT ADDRESS <br />-��MRN ��o✓nt i C�IIAr' �.�11 ��1Trl ST �V�i1i`7 ��� L�Z-S��I�ii-53�� <br />Owner' Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />20G- �91` <br />1L�►�NYok�� ��<<Tn,�� �� C 2Z�� �v� 2Srr�7 S-r• 2t���w �.�l 4�u S� G ti 26 <br />Electrical Contractor Mail Address City State/Zip Phone <br />o�- _ <br />�P i« ,�Y�� k��M� i / I ��' <br />State License Number (required) City of verett usiness License Number (required) <br />�i,�`Siot�l7rp � <br />Proposed Use of Building <br />Ll� <br />Square Footage (If residential new constructio , remodel o addition) <br />Number of devices (If low voltage) <br />`�` b u �i <br />Contract Price of Work <br />/�� CM� S za6 —1�4'C� 2.0 <br />Contact Person/Contact Number/Email <br />M� rc�2�ro� � ho�'r.�,. I. CO,,.� <br />Description of Work to Be Done: �rV� 1(l � 1�1+Sr�^i�N7 ��Lpl�JO,.� C��jC7' � i7A T/�/ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that ! have read and exami ed this application and know the same to be true and <br />correct. All provisions of laws and ordina ces governing this type of work will be completed <br />whether specified he in or no . The gr� ting of a permif does not presume to give authority to <br />violate or cancel t e visio . of any her sfate or local law regulating construction or the <br />performance of on r ctio .;'That I a authorized by the ownerof this property to perform the <br />work for whic ap ic ion is made d I comply with the State Contractors Law 18.27 RCW and <br />296.200 W� / � <br />ature <br />REVISED 08/O6/2014 <br />uate <br />FEE <br />�� �� <br />� <br />PERMIT# <br />E Ir�Cj 7' �/� <br />