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�������A�.�V� �����`� ����p�.��0��1 <br /> �I�"� �F EVER��'�' ��RMIT ���Vi��� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - fAX 425-257-8857 —www.everetlwa.org g _,�({ ��� <br /> � I ��� G � <br /> 3 ��� �v�i�uy /�r� ��er�7� <br /> PROJECT ADDRESS <br /> �QG�'_y /// S 7I� ��l h`✓C' �1/t��e Gt�Q . `��.�Ln Sl�� <br /> F��- <br /> Owner7—� MailAtldress Ciry Stale/Zip Phone <br /> Tenant Mail Address City State2ip Phone <br /> /l/,�� a �/G s`�is ����5� SGl� FdGl�,r�' cc/a . �P�a� 7�y 9S�a9 <br /> Electrical Contractor A1ailllddress City StatelZip Phone <br /> �oj� �o t � /73 �� G ,�___ S 9.9�6 <br /> Slate License Number(required) City o(E erett Business License Number(required) <br /> -� DO <br /> �'es- � 5�' - <br /> Proposed Use of Building Conlracl Price of Work <br /> � a�6 �iy-9ya9 <br /> oZLk�- v �t�v/ C��i� �a r c%v_�[:nt�s� , <br /> Square Footage(If residential ne�v construction,remodel or addition) Contact Pe on/Contac�mail /�/p f i <br /> � i <br /> Number of devices Qf low voltage) <br /> Cescription o(Wark fo Be �one: NeW `� �—_,(���(' � /f G Gf / � _ <br /> � <br /> fEE v <br /> CI7Y OF HVERETT LOCAL SALES TAX CODE IS 3105 /„ /�� <br /> / lJ <br /> I hcrr.by ccrti/y thaf l l�avc rcad and exarnined(his.ipplicafion and kno�v fhc samc(o he lruc and _ _ <br /> conecL All provisions o/la�vs and o�dinancr.s governing Ihis type olwoik will be comp/eted ---- <br /> �vhelhr.r specilied herein or noL Thc gran(ing ol a pennit does not presume to give aufhority(o pERMITlI • <br /> violafe orcanr.el fhe provisions o/any ofher slate orlocal law iegu/afin9 constnic(ion orlhe /, <br /> perlamtance ol cons(ruclion. Tbaf I ant authorized 6y the ownero/this properly fo perfomr flie E ��Og ' �,�j (� <br /> wodc lor wAich applicalion is made and I compty wilh(he Slale Confrxlors Laiv 18.?.7 RC W and <br /> 296.7.00 WAC <br /> -�� � �-=-��-���-- <br /> i nat rc / Uate <br /> r'CVISFDnrmG/7orJ <br />