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�L� TR��: L ��� 1 ���LI�i4�10 <br />CITY OF EVERET"f PERNIIT SERi/ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />2C� � 1 e��.�D�� �,� � <br />� �--.�L:��� �� � ���_. -��-����, G �/� `r�j��-'-�'i 7 <br />, <br />PROJECT ADDRESS <br />�r ���` �i�,�,. <br />Owner <br />%" x <br />-enant <br />��' /���i/'�'i / �: ij G-�i( ili �� <br />Mail Address <br />' � C� .� �1,��'1�2 <br />Electrical Contractor <br />/� % � �iN.� � <br />Mail Address <br />State License Number (required) <br />Proposed Use of Building <br />Mail Address <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />T� <br />City <br />i� <br />C ity <br />City <br />�Yz�� �1��--� % � <br />-<=_ � f1= .ir�� h c> i�,'s�i, ��/�9 9'� 9� <br />�� <br />State/Zip <br />z�� (vzs� <br />State/Zip <br />State/Zip <br />Phone <br />� <br />Phone <br />Phone <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: �% � !�'1 �� ��'Z� � ���� � fi ��I<<'' � �� �r'� � �t �� � ���' � � <br />� <br />� O �� � E' C3, -� `�--�„� �, !�� . _ <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � 9�q�" )y �,,/`� <br />A� rr <br />I hereby certify that I have read and examined this application and know fhe same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br />violate or cancel the provisions of any other state orlocal law regulating construction or the �-� <br />performance of construction. That I am authorized by the owner of this property to perform ihe E�C')� ��(� 2 �J <br />work for which application is made and I comply with the State Confractors Law 18.27 RCW and � <br />296.200 WAC. <br />G�.'1���-�F�`�' 0��-��-' ( / .� <br />re <br />ate <br />REVISED 08/06/2014 . <br />