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�L�c-�ic�� ����a-r��'��o���-��� <br />CITY OF EVER�Ti PERMI�' SERVICES <br />3200 CEDAR STREET, EVERETT, NJA 98201 <br />425-257-8810 - FAX 425-257-8857—wwn�d.everetiwa.org <br />��7 l,cc�5� <br />PROJECTADDRESS <br />t �' 14 <br />Owner <br />Tenant <br />��o �;:� I �-I'] <br />Mail Address <br />G�ua:���JtEw' U;IFr` <br />t.iail Addres^, <br />6—I �—�S <br />� i5 �- p7Z- <br />�vr�L�7- L �� `=j�?.oi <br />C�ry <br />Cily <br />StateiZlp <br />Sfale/Zip <br />Fhone <br />Phone <br />r <br />I^D'�: w," Z,i' i(: ',, o � f? � o c� <br />'�c —1 I'b ;;,;jc icI Iti-+I-���ia��� L..•q. IJG�'S ��I�i�SlZ-2o�"L <br />GlectricalContractor tvtailAtltlress City StatelZip Phone <br />i� <br />��,.�p�;�rs_ 3����<�� ��-�iy <br />Slale Licerse Number (required) City of Everett Business License Number (required) <br />i'J%1: i ✓�tiLriv l J <br />Proposed Usz ol Building <br />Square Footage Q( <br />� <br />new construc�ion, remodel or addition) <br />Number of devices Qf low voltage) <br />� <br />Contract Price oi Work <br />��S C`l/,-3.(t-Slh1 i Sc-Ww9�;w+2� ���,��i,�'✓.,4:�i <br />Confact PersoNContact NumbedEmail <br />DescriplionotlNork�oBeUone: ��CS�'"11L/ (�7"C`�s�`J 5•9ViNl• f�,cln�'�Lc`7���flNj- G� Li(�rl7..s; � <br />f <br />'�nn; ��,-�s � i�aa:��c rt��,>> , 3 u.,:.ti�n <br />CITY OF EVEREI�' LOCAL SALES TAX CODE IS 1105 <br />( hereGy certily that I have rzad and examined this applicafion and kno�v fhe same to 6e (rue and <br />correcL All provisions ol law, and ordinances goveming this g�pe ol work �vill be comple(ed <br />whether speci6ed herein or not The granfing of a permit does nof presume fo give authority to <br />violate or cancef the p�ovisions olany olher sfa(e or local law regWating construcfion or fhe <br />pe�(ormance ol consbuction. That 1 am aufhorized by fhe oivne� o/this property to peAorm the <br />ivork /or ii�hich applicafion is made and I comply �vith the Sta�e Contractors Law 18.27 RCW and <br />29G.200 VVAC. <br />Fe c,sea o°�ar,za u <br />.� iti=� .� U � � I <br />Datf <br />Z� L� 7%� �= i-1 i� <br />F[E <br />�-15 v0 <br />PERMITi; <br />E 150(�- ��2 <br />wi i. c:.:�, ���i <br />