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� <br />! <br /># � � t� � �a l �` , 1 �,, �,�� . I — <br />� . <br />, m � � z . �..,� .� <br />. �-� > --� , �:� � � <br />r i.�,N 4c �„� i� 7 � f ���.. <br />6�I ����� L'�!/ �1\� 1 1 1�f`�IV1� d��S,AV ���� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />���`�� G.������c� ,�� <br />PROJECT ADDRESS <br />L U < <br />Owner <br />r�� <br />Tenant <br />�� � <br />�'..--��'�-��"�'� <br />Mail Address <br />Mail Address <br />Electricaf'Ci'ontractor Mail Address <br />���� <br />��� �' �� _ �C=1,��0 <br />St e License Numbe <br />� " .. <br />�, �'�/ Gr% <br />Proposed Use of euilding <br />����J.�-,��- <br />Square Footage (If er sidential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />.� <br />Description of Work to Be Done: �j E� <br />�C �� �� ���/ <br />City State/Zip <br />City <br />State/Zip <br />Phone <br />Y�'r-1 <br />Phone <br />�� ��� .�: ����L�'_ �%�_ c �� <br />City State/Zip Phone <br />� �, � �JF�. �Gz.�r/�' <br />���— -- --- - --- -- <br />Con(racl Pri e of Worlc <br />�� <br />� : <br />Contact Person (Pla Review) <br />�'� 5 ( �f � � <br />�-''��'-��<�' i ���'�,�',� r <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby certify fhat I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this fype of work wil! be completed <br />whether specified he�ein or nof. The granting of a permit does not presume to give auff�orify to <br />violaPe or cance! tl�e provisions of any ofhe� staie o�local law regulating construction or the <br />performance o#�p nstrucfion. Tl�at l am authorized by fhe owner of this property to perform the <br />work for whlc��pplicati ^� nd ! comply witf� the State onlractors Law 98.27 RCW and <br />296�,200 W/a'C. <br />� � i, � <br />.��' � � ;, ��` � � <br />ature '�' - 'Dafe <br />FEE <br />..= ;G � <br />�--� � _-- <br />PERMIT# <br />E � � �Q � �0 �-, <br />