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� <br />� <br />�V���TRV��e� P�I�N���' ��ff��,B���1"8Q0��1 <br />CiiY OF EV'Ef�ET7 PERf�Ii� S�RifiCC� <br />37_00 CEDAR STREET, EVERFTT, V�lA 98201 <br />425-257-8810 - FAX 425-257-8857 — �rn�nv.everettvaa.org <br />13os S� � E�ii v��-�� ��v <br />PROJECT ADDRESS <br />1C1 '4'_L—��-"����'`� <br />Ovmer fvlail l�ddres; C�ly <br />Tenanl <br />Electrical Conirador <br />Slate License Number <br />Rest �+��u�Cr <br />Praposed Use of Building <br />Mad ACdress <br />h9ail Address <br />LN <br />Square Footage Q! residential new conslrudion, remodel ar add�ion) <br />City <br />Gty <br />Slafe/Zip <br />Staleilip <br />SlalelZip <br />`7 �-I / `-� �� <br />C-I�{6��-��� <br />�...�1�-�� � <br />Cemrad Price of Work <br />Con�ad Person (Plan Revierv) <br />Phone <br />Phone <br />`1 �(p <br />Phane <br />Number of devices (I� lovi voltage) <br />Description of Work �o Be Done:C. L�r�ly() �u� el� ( �� �CYV �a��� �(� �� �' �`��� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined Ihis applicafion and Imo�v (he same fo 6e (rue and <br />conecL All provisions olla�vs and ordinances goverr,ing (his type o( v�od< <vill be compleled <br />•�vhelher specilied he�ein ornoL The granting o7a pemiif does nol presume (o give au(hority 70 <br />violate or cancel lhe provisions o( any other s(a�e or local la w regulafing construcfion o� the <br />perloimance o(cons(rucfion. Thaf I am aulhonzed by (he o�^.�ner of fhis propeRy fo pedorm Ure <br />vor or which applicafion is made and I comply with fhe Slate Contractors Lavi 1827 RCW and <br />2 6 2 0 WAC. �� „ <br />fEE <br />57 5`' <br />PERMIT� <br />E I�{�7-67� <br />