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— ------� -- --.— --- <br /> ��.���E�����, ����li �� ���' i�B�����h� <br /> �9�� �F �:9/���'Y�" ���3'�9'� ���`�I��� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� ��_/,� <br /> 425-257-8810 - FAX 425-257-8857-v,nvw.everethva.org <br /> q--1 � --1.5 <br /> `2y� � . 1�( st F_ �c���' 4�as< q �2o3 <br /> PROJECT ADDRESS <br /> �P9C ���jo7 SF 7� P� 9�1 �(Iet,Jcc.-S1-Ge �✓/-� . �8 �56 <br /> Ownef 69ad Address City StatelZip Phone <br /> I <br /> Tenant t�dailAdtliess Ciry Slatc/Z�p Phone <br /> , C zs>3,S�8 yo <br /> /��e,�t El��r. �� ra �o! Cyrus4�4� s�`�ios nn��,�ctco vu�2�f <br /> ElectricalContractor �dailAddress � C�ry State2ip Phone <br /> I ��r�t EL �W�� r3�� <br /> State license Number (required) City o(Everett Business License Number(required) <br /> $� �b0 .°� <br /> Proposed Use of Building Coniract Price of Work <br /> Square Footage(If residential nevi conslruction, remodel or addilion) Contact Person/Contact NumbedEmail <br /> � � <br /> Number of devices(It bw vollage) <br /> Dcscription of Work to De Done: _��[„J[�T�L �'t U A' �`�'����N G�r^'��� fLUr �iStB v,v�t�'" <br /> �OD FGevaTor S_�2E3 Po�NeG �Nl� F�VAL _ <br /> FFL• <br /> CITY OF EVERETT LOCAL SALES TAX COD[ IS 3105 � 22� � �� <br /> i,t-� <br /> 1 hereby certily N�af!have rr.ad mid examined(his applicafion and know fhe same fo be frue and <br /> cormeL All provisions o/laws and o�dinances goveming fhis typu ol woric H�ill be completed <br /> �vhetherspecified herein ornoL The 3ranfing ol a pemiit does nof presume to give authonty to PERMIT� <br /> vio/afe orcancel the provisions o1 any ofherslafe orlocal laiv regtdafing construction or the � ��h/� � I�]l <br /> peiformance oI cons(ruction. That I am authonzed bylhe ou�nero!fhis property lo peAorm the U"� ,I.J <br /> �vorir lor which applicalion is made anA I compty w�ith the State Confracfors Law 18.27 RCW and <br /> 2962D0 WAC. <br /> .�- ��/�� GJ—!7 � /-� <br /> - Si9� e-- -- Dale <br /> PFVISEOOb9Y.'OIJ ______ <br />