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� , � . � � .: � �,� .,$, f �`' �;,. �e i�t ��} '� : i � ..v - k�:� �� :��! �j k �' �`' .��, e e /'•v t FI <br />CI ! � �� ������� ���IMII� V��Y I��V <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />`7d� ����"� �� s�a k veaE �� wh `3� 9�ac <br />PROJECT ADDRESS <br />C'e PPE25� � � nl <br />Owner <br />Tenant <br />�:�P I,Q� <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />Cv�2E E4cT�2tc /'•c�� �.� �3t�� �d�c,�,.�a��i.e i,,.h 98z,�.� d�c S�ts-��33 <br />Electrical Contractor Mail Address City State/Zip Phone <br />Ci.veeEEL£�il:•�1 kw. <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Gs3 c y ( <br />City of Everett Business License Number (required) <br />� r����J . �,� <br />Contract Price of Work <br />Contact Person/Contact Numt�er/Email <br />Description of Work to Be Done: A��7 i�c ,a�P 5� .3 °A.� L�`�2 �t.� �Asn t�v���°�a�r� .,g�� c iQc� �r •� ,v�z.� �� a?ati� � <br />Tl�� SN Cv,� P <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerfify that I have read and examined this applicafion and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this properfy to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />uate <br />REVISED 08/06/2014 <br />FEE <br />���,�� <br />PERMIT;�# <br />E I�I � -��2�� <br />