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� <br />�L�C�ICAL F'�RM11" APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8II57 — o�/ cut.[J.�: �'�,'Z�"� wtz � y�U ✓ <br />�i„ 1�. t�����+�eps �e� Gf�"r,uJ-�;�+1 g``� <br />� ,�, `, �E;- a�� 5 <br />�i --� ,, , <br />(�3 .S �.I i.i i..l �aC.'� ..i <br />PROJECT AL?DRES3 <br />OWnEf <br />Tenanl <br />'L�� � � i'D �ii%+ I 17t1"% <br />Mall Addre;s <br />C'iiiU�i��tt �17 Nlr�iy. <br />Pdall P.ddress <br />c`��,cG�7- <br />Clly <br />Clly <br />�iSDg-l�9 <br />L �, `l � z��� � <br />Statel'Lip <br />State/Zip <br />Phone <br />Phonc <br />��VU:��L=l.:�i� ����TI�IC� I"6 rJJ�t ''��f.� V4-lln-�iLi.d��,i?� i�..�q `��'��L'� <br />�`l2a � 822 2u � `L <br />ElectricalConliactor MailAdaress City StotclZip Fhonc <br />,n� �b"� � 7? ��� ��, � U � ��I <br />StaL �icenso Nwnber (requlred) City of Everetl �usiness License Number (mquired) <br />I�GI�;'��'li.��t S <br />Proposed Use of Duilding <br />Square Foolage (If residentlal new construction, remodel or addition) <br />IJumbor at d�vicas (II Iow volinge) <br />� <br />ti <br />Contract Price of Work <br />T.� C���zn� rsa-�,w���2�e.,,�,���u.,c <br />Conlact Person/Contact NurnbedEmail <br />Descripfion uf Work 10 0e Done: CCS��,�1L� ('��C�,y SA'JiN � itil��H�i�tbtiid7�-�- C�T— l��L; iT�e � <br />`�.�1"('l.� F-/\N>_�_IZ�I�I�I' F�-�J$ 7 G!lLt;r�i7'� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hen36y certily fhaf 1 have read and examined thL^ appllcafion andlrnoiv fhe same fo Gc (rue and <br />correcL All provisions ollaws and orJinances yoverning fh�s type ol worlc will be completed <br />vihefhcr speciliod hercln or noL 7'he granling oI a perml( docs nof presume fo give auUtority to <br />viola(e or cancr.! fhe piovislons o( any ofher sfa(e nrlocallaw reyulat6�g cons(ruction o� the <br />perfoimanco ol consfrucflon. Thaf / �rn aufhoiized hy the o�vner of this prope�ly fo perform tho <br />�vork �or which application ls made and I compfy vr,'th (he State Contrac(ors Law 18.27 RCW and <br />296.200 WAC. <br />reveracaNa,zo�+ � r �C. 7L) L, (� <br />FE[ <br />,�SD no <br />P[RMITit <br />E 150�- Il�j <br />