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— —�---- -- •-- <br /> �����'R��AL f���(�i IT �►���.O�l����I� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �,�a8-lS <br /> 4Z5-257-8810 - FAX 425-257-8857 -www.everettwa.org � <br /> ��56-� _!8 <br /> i o �<� � ��- �z <br /> PROJECT ADDRESS <br /> r�-rµw �-rr�mr�c l�� o l��'i �� (� '� WAS�v�I 2�� <br /> Ow'ner MailAddmss City StalelZip Phone <br /> Tenant Mail Address Ciry State/7_ip �� � Phone <br /> a' yzS <br /> �k2a 5,���c� ���� � P� (3c�x i� 6i��� w� �ar-2 ,, <br /> [lectrical Conirector Iviail Address Ciry StatelLp Phone <br /> ���5��7 �C� O�O I �S <br /> State License Number(required) Cily o(Everetl Business License Number(required) <br /> AP �2Tm�� <br /> Proposed Use of Building Cornract Price of Work <br /> Square Footage(If residential new consiructioq remodel or addition) Contact PersonlContact NumbedEmail <br /> Number of devices (I(low voltage) <br /> Oescriplion of Work to�e Dane: F-�Y ��.Cr.'�- �U_f��1���"'� L ��e`� -- <br /> SN���L,`- __��-�7�� ���SLv_LT�.-- -- <br /> f-EE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 In� �� <br /> �(/ <br /> !hr.iehy ce�tily Ihaf I have read and examineJ this epplicafion and fcnnw Ihe samc fo bc truc and ,____ _ <br /> correc(. F�ll provisions o/laws and nrdinanr,r.s goveming fhis type ol woik will be completr.d — <br /> whclher specilied l�erein o�noL Thc granling ol a pe�mit docs nof pre,;ume to give aufhonty(o PFRMIl�O/ <br /> violafe or cancel(he provisions oI any olher stale or local law�egulatin9 construc(ion or Ihe � `��� , I� I <br /> peAonnance of cons(ructron. Thal I am au(honzed by(hr, owncr of this propmty(o perform fhe � <br /> ivorlr(or whicl p icalion is made and 1 r.ompty tvi(h Ihe Slafe Confrac(ors Law 78.27 RCW and _ <br /> 296.200 W . <br /> �— ��2�/�� <br /> ��� -- <br /> ----5i--- --- -� — "—.Ualc <br /> PFVI'F U Otl/Jc/:01 J <br />