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ELE��RI�/�l� P�i�IVil�' A�PL��A�'ION <br /> CITY OF EVERE�'7 PERMIT S�F�uICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> �.�5 (`�l hl , O.t� • <br /> PROJECTADDRESS <br /> (�i,�tTnw-�`cl��1��' clsl� C�l �P� l�L1 µX 0-l��- 13��- <br /> Ovmer tdailAddress ity Stale2p Phonc <br /> Tenanl MailAddress City SlalrlZip Phonc <br /> �� +� <br /> rrw-�,n ���-E,�-,� � ► r� ��� �"'�. - ;Ile.l� Q�� 9q£s3 <br /> ElectricaiContractur MailAddrcss Ciy State/Zip Phone <br /> m___L_i�r��FsS�J-��- �� I <br /> Stato License Num6er(mquire� City of Everett(3usiness License Number(required) <br /> �(`C1��P. �-Ca�Y1���Li— �� �—}� <br /> Proposed U f Building Contrad Price of Work <br /> �-+�+�,. ��r� � - ��_ <br /> Square Footage(If residenliai new construclion, remodel or addition) Conta erson/Contact Number/Email <br /> Nurnber o(devices(It low voYage) <br /> Descriptian ot Work to Be Dane: �j��� �T_-��� -� J�y�� <br /> FEE <br /> CITY OF [VEREIT LOC/1L SALES TAX COD[IS 3105 '1/_ �� <br /> l;l <br /> 1 hernby cerGly fhaf I have mad nnd examined this applicalion and know the same to be fruo and <br /> comtcl. A!I prnvisrons of lows nnd otdinancos goveming Ihis type ol work will Gc complefed <br /> whelhcr spec�licd hercin or noL !he giantln9 o/a permit does not pmsurne lo givo aufhonty(o PERMRN <br /> vio/afe orcencellhe provisions of eny ofhersfafe orlocal la�v rcgulafing consfroch'on or the r `�O� � I � � <br /> peAormance of construction. That I am authonzed by fbe o�merof this propaty to peAorm lhe C <br /> wo�k(or which applica6'on is made and 1 comply wifh fhe State Confracfors Law 18.27 RCW and _ <br /> 296.200 WAC. <br /> C( '�--�5 <br /> ignaNm Date <br /> ltLYIYU(110YJOIt _____'______ <br />