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� <br />u <br />ELE�TRI�AfL PERMO�' ��f��oCATO�i� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />�3i �� �a�iso� Sf _ <br />PROJECT ADDRESS <br />Owner <br />Tenan� <br />' ��-�-��P �u.c <br />A4ail Address <br />� dx�ccc� ✓�3/ <br />Mail Address <br />_--����c ��`i✓/rc <br />Elecfrical Conlraclor MaitAddress <br />Sfa�e License Number (required) <br />Proposed Use of Building <br />Square Footage (If residenlial new construction, remodel or addition) <br />Number of devices (If Iow voltage) <br />Description of Work lo Be Oone: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /><.:-Luls�s/�0 �f <br />Cj�(j—l> <br />2� ��d-�E <br />32�3 _ �,' �� ��-� � r,v,¢ �k'a 8 <br />City <br />City <br />City <br />Slaie/Zip Phcne <br />� � %t�2°� <br />StalelZip Cl/ ZS--� _ P�ne ' <br />�Z� � <br />� �r-� '-�- `�/�c7�'"3 <br />State/Zip Phone ( <br />�a—��p ...-7 <br />Cily of EvereQ Business License Number (required) <br />� �� � <br />Con�ract Price of Work <br />�'r'C �2�'i ✓1 Z �6 �7q�`"1� <br />Conlact Person/Contact NumbeqEmad <br />C��CG�P y�qN4 �P4 �'%j, c c�� <br />� <br />1 hereby cerlily that I have read and examined fhis application and know the same to be liue and <br />conecL A/l provisions oflaws and ordinances goveming this fype oI work wi'I be completed <br />�vhether specified herein or not. The granting o( a permit does nof presume to give aolhonly to <br />vio/ale orcancel (he provisions o/any others�ate orlocallav� regulating construclion orthe <br />peAormance o/construction. That I am aulhonzed by the ovmer o/(his propeRy fo pedorm the <br />wo�k for �a�hich applicafion is made ar,d I comply wifh fhe Sta(e Con6ac(ors Law 18.27 RCW and <br />296.200 WAGi, <br />�/ 5� <br />�e � ,1d <br />FEE <br />J�O�� <br />PERMIT# <br />�wls�s-ooy <br />7r <br />2 <br />,3 <br />