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L��� �� : ��� ������ � � <br /> CITI( OF EVERET'T' PERIVIIT SERi/ICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> � � <br /> "c' �� � � �� u � �r�. i=��,�� � � � � �� <br /> PROJECT ADDRESS <br /> � <br /> E-��� %.� I�Z�Z� l ��� <br /> Owner Mail Address City State/Zip Phone <br /> ��' � � <br /> ' � �%`� j Z �o L � � i:r�_��.�` �—�� l ���� �� <br /> L. <br /> Tenant Mail Address City State/Zip Phone <br /> 5 C'.' ( "'3-- ' <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ��e�a �c; <br /> s� � <br /> State License Number(required) City of Everett Business License Number(required) <br /> � <br /> �� ��lii ��lr"t'�� <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: i'�(-' i�° � ;'� � � ���T�''c r �-�- � % �� �%��G'Er �`�i'�'`t"s - <br /> FEE �" <br /> `� '� - � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 - '� <br /> l hereby certify that I have read and examined this application and know fhe same to be true and � <br /> correct. All provisions of laws and ordinances governing fhrs type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulafing construction or the <br /> performance of construction. That 1 am authorized by the owner of this property to perform the E (C��;� �� �� <br /> work for which appl' afion is made and 1 comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. � ^ <br /> ,'�—L� �i.,�� � <br /> 7 �� � l,� <br /> Signature Date <br /> REVISED 08/06/2014 <br />