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������a�,�u�. ��:���-� �r���,����o�� <br />�I�,�P �� EV��Z�`d'� ��R�li��" ��R�/���� <br />3200 CEDAR STRFET, �VERETT, WA 93201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />Izy (�q��.so� s-r- �v���-rr-� v4 <br />PROJECT ADDRESS <br />E LCE .� <br />Ovmer <br />Tenant <br />Electrical Contractor <br />Slate License Number (required) <br />Proposed Use o( 8uilding <br />1 Z �I fYl R <br />Maii Address <br />Mail Address <br />Mail Address <br />I �C�U SGZ -fi7' <br />Square Footage (If residential new construction, remodel or addition) <br />tJumber o( devices (If low voltage) <br />r �vE eE1T lJR <br />Ci!y � Slate/Zip <br />City Slale/Zip <br />E �so8-�7 y <br />8,as_i � <br />(4�) 555- <br />ISy � <br />�z U3 <br />Pho��e <br />Phone <br />City State/Zip/�\ 71�—�PZZ <br />��J J <br />�Q� - D `��p I �S�CQ� <br />Cil o` Everett Business License Number (required) <br />� S66 <br />Contract Price of Work <br />Contad Person/Contact NumbedEmail <br />Description o( Work to �e Done: �E�C 6}-I F� �(LL��' T� �'t /C �'�`�T <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereGy certily fhat 1 have read and examined Ihis application and kno�� the sarne to be (rue and <br />corre�t. All provisions olla�vs and ordinances goveming this type ol work will be r.omplefed <br />whefhe� specified he�ein ornoL The granting of a pennit docs not presume to give au(honty to , <br />violate orcancel the provisions of any olher stafe or/ocal law regulafing construction orthe <br />peAomrance o( construclion. That I am authonzed by the ownerof fhis properfy fo peAorm the <br />wodc lo��vhich application is made and 1 compty with the S(ate Confractors Law 18.27 RCW and <br />Z S/ Is" <br />r.evrseo ae�asiID i. <br />FEE <br />� �JD��°i <br />PERMR# <br />E 1.�� 1'l�. <br />