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����-r��c,�L �E�nni-rA� <br />i�icA-r <br />i�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - �,.:' zu :.� -� ��'�-�,�:�"'-r� V��� . ��? � <br />i? ltiti�,� t � . .� t/L v'L ��" � -�: �% S � t2 x /,:.y�,,T""D� �c�J�_'e� • �� � i��'' i�� . <br />� <br />j _S �? :.,_ � C�._�+,"ji�. r'�..i �� <br />PROJECT ADqRESS <br />t�<<� — S' D,i z� <<?'� j 7 �.,_ � i:1�;::�J' <br />Owner <br />GI'w1t`�f?�v' iL �v C.:•�r,'`i � <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />c. <br />LJaa ��C�ZG�f <br />~ State/Zip <br />State/Zip <br />Phone <br />Phone <br />���� l.i:L% �L i.,;.�� {? . �l._. LG'�i71�% l %,a �'b i>, � � 41,r i t � .� � � E'� �' i G'� :' <br />l� U l _..� 1-'�/�-'viJr 7 �.� 7J, (,> � �.' .� �''� ?.� � � �� � � Zf.� � (� <br />ElectriCai ContraCtor Mail Address City State/Zip Phone <br />�I <br />i���'��i����� z 3u� ��`� �� �- �. �`j <br />5tate License Number (required) City of Everett Business License Number (required) <br />�'�i��,j�'��i:i,�jti� � L�� ")� <br />. <br />Proposed Use of 6uilding Contract Price of Work <br />Square Footage (!f residential new construction, remodel or addition) <br />� <br />Number of devices (If low voltage) <br />� l'1 C'"LV.T�. (:-�t� 1J ! S C• — YVw � W t1aT'� 12? ,�r ,,.; �-i r.� v, t <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: ���5�'LLJl-1L-� L��z�;;� `y� 5-'�� i N � ia t-�"�.,.����y�.i�7��- ��}=- (. iC;-i'r "c � <br />''d a'a'i�-1 4=� r� � (�; �:�; �:: l:� �-�:: ti j� �� G t r� ..t c.r r�-..� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby ceriify that ! have read and examined this applrcation and know the same to be true and <br />correct. All provisions oflaws and ordinances governiny this type of work will be completed <br />whether specified herern o� not. The g�anting of a permit does not presume to give authorify to <br />violate or cancel the provisions of any other state or local !aw regulatrng construction or the <br />performance of construcfion. That l am authorized by the owner of fhfs praperty to pertorm the <br />work for which application is made and l comply with the State Contractors Law 18,27 RCW and <br />296.200 WAC, <br />ture <br />REV(SED 06/OG/201�i `,'2, +' � � �j� /,� � <br />f•/ L/ 4� (-� <br />FEE � <br />� �V ��iC�� <br />PERMIT# <br />E i���� - I�Z <br />