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PROJECT ADDRESS <br />ream G19C <br />Owner <br />Tenant <br />Electrical Contractor <br />• <br />C] <br />CITY OF EVERETT PERIVIIY SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 % `0� <br />425-257-8810 - FAX 425-257-8857 — www.everettvil g 7 <br />C—►U07 -00/ <br />Mail Address City Slate/Zip Phone <br />Mail Address City State/Zip Phone <br />s. 9�30 -2 <br />Mail Address <br />S6W-7W467/077e W <br />Stale License Number <br />Cc) o7 /72M c//jz:� <br />Proposed Use of Building <br />Square Footage (If residential now construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Bo Done! <br />j'57 979 <br />CITY OF EVEREl T LOCAL SALES TAX CODE IS 9105 <br />City Slate/Zip Phone <br />'z go, O O <br />Contract Price of Work <br />Contact Person (Plan Review) <br />1 hereby cattily that I have rood and examined this application and know the same to he true and <br />correct. All provisions of laws and ordinances governing this typo of work will be completed <br />whether specified herein or not. rho granting of a pemiil does not presume to give authority to <br />violate or cancel the provisions of any other state orlocal few regulating construction or the <br />performance of consfrv5 ' hat I am authorized by the owner of this property to perform the <br />work for which appli5 ion ism o and 1 c ply with the State Contractors Law 18.27 RCW and <br />296.200 Wi <br />O/ rl JG <br />/T- 420a9 <br />ern ey, <br />(100 <br />PERMrrt <br />E I4o-7-60I <br />