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.: <br />; ,. ;. <br />m <br />� <br />»_:: <br />„. ._ . <br />. � s,, - , �,: �f. :. > .. <br />EL�CTRICAL W �' .��1T AP�����''a' �r �N <br />CITY OF EVERETT pERMIT SERVIC�S <br />3200 CEDAR ST,REET, EVERETT, WA 98201 <br />425-257-8610 - FAX 425-257-8857 — www.everettwa.org <br />�1 � � ' � � � % <br />- <br />Owner � <br />Tenanl <br />Electrica�� � I Cont� <br />Mail Aatlress <br />Mail Address <br />Mail <br />1� 1,L C(� �c �(2(',( o <br />��ate License Number (required) <br />���= R <br />Proposed Use af Building • <br />Square Footage (If residential new construction, remodei or addition) <br />Number of devices (If low vollagol <br />Description of Work to Be Done: <br />City <br />City <br />C� <br />�=l 4/O-o,sl <br />/O -7 -/ y <br />nI C3 bb� ��u - ya-, <br />�k�. �ve����1 d�Z03 <br />State/Zip <br />Slale/Zip <br />Phone <br />Phone <br />`L� i�l�? ��-7`1/v-3 <br />Slate/Zlp <br />Phone <br />c��Dl��- <br />Cily of Everett Business License Number (required) <br />Contrect Price of Work <br />Contact PersonlConlact NumbeqEmail <br />t <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I horoby cortily I t/ havo read and examined I�tiis application and know tho samo fo be true and <br />correcL All pro s ns o//aws and ordinances c�ovorning (his type o/work will be comple(ed <br />whe(her specifi d erein or not. The gran(ing of a pormit does not presumo �o give au(honfy fo <br />violafo orcance th provisions olany ofhorstafe or local law iegulafing consWction or (he <br />peAormance ol onstrucfion. Thaf 1 am authorized hy tho owner ol (his p�oporty to peAorm fho <br />work !or which n lication r made and I comply with fhe S'afe Contracrors Law 18.27 RCW and <br />296.200 WA <br />l ���11 �f <br />FEE <br />✓V� <br />PERMIT# <br />EI�} [b-os� <br />