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------ � � - -, <br /> � I <br /> ELEC�RI�/�L fPER�VIIT' ,�4PiPL�Co4TO0�1 � <br /> CITY OF EVERETT PERPJIIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wwef.everettwa.org <br /> i <br /> � <br /> 98/� f� � �y �/zlv� �/-� Zo � I <br /> PROJECTADDRES.�, I <br /> � � E�,� �E—,�c�a 98 i.f �o ��y oR �t z� , �6��> wr� Y�"�� ,� <br /> 0�•mer IAarl Address City State/Zip �� ^��;e II <br /> J � <br /> Syb j <br /> �I Tenant f�iail Address C�ty StatelLp Phone <br /> IBcuE �G/38on� �����ie �{ n�t. ,?GT�3 2 82�.l� �Yui.` c./E57 �,D�Lio.✓tl S G/r} g�j2.� ': <br /> EleclricalCoNrador �+�adAddress Gty Staie2p z� 22��29e�k � <br /> �� I3� uEkF-2 1 � � QN _— 02��J3� <br /> S�ale Li[ense Number(required) City of Everett Business License Num6er(required) <br /> � U L T� /Ll�t.✓� /Z E� _— Z6Y�b ' <br /> Proposed Use of Duilding Contract Price o(Work �, <br /> �'l�Ti�✓ /�vd 6� <br /> Square Footag^ (I(resideMial nevr consiruclion, remodel or addition) Conlact Person/Conlact NumbedEmad <br /> �zo� - 22�- �9sy <br /> I /9 o d'q e lD � c�n�.�a.�F ,n e'�' I <br /> Number of devices(If low vollage) �� <br /> I Description nf Work to Be Done� . /j �t� �U/`� �� �a��` , ��20��� � �D v� — - __ <br /> � �— �-- <br /> CO/+�Nl.lqnll fj��-� �lt�T Fa2 LrG f 6Jr�P �, '%�? �20/ -- ' <br /> /�L�C -- — --- ---- - <br /> FFE <br /> � CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 I � Z .5 � <br /> l <br /> I hereby ceRily(hat 1 have read and examined(Iris application and Imo�v Uie same!o be trve and —._I <br /> correcL AII provisions ollaws and ordinances goveming this type of work ivill be comple(ed <br /> �vhefherspecified herein ornot The pran(ing ol a pennif does not presume fo give aulhonty to PERMIT?t <br /> viofate or cancel lhe provisrons ol any ofber stafe or loca!lav�regulafing consWclion or the � ��O� _ / O � <br /> pedormance of consWction. Tha:I am aulhonzed by fhe o�vnerolthis propeRy fo peAonn(he <br /> �•✓ork lor�vhich application is made and I comply�vith the Sfate Contractors Laiv 18.27 RCW and <br /> 296200 WAC. <br /> ��c� � ,/ ��- a / 7 (� <br /> , Signature ��ale <br /> Fewseo cs�cy:or� <br />