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r � " <br /> �� ������� ������ ���������� <br /> Cil'l� OF EVERETl' PERIVIIT �ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> _.5/`3/__�G���r✓-�'�� �:%"�"'� �i��r2��' t�'t/f� �j�'Zc��� <br /> , <br /> PROJECY ADDRESS <br /> if�Yj�r i��l c�l.�// /�C%f 7 �7i�i 1����� L��'-/��c�1-r�%/S �'I/Jq' i� 'l�> tf'�;773 2 J'� <br /> OWner Mail Address City State/Zip Phone <br /> Tenant Mail Address City StatelZip Phone <br /> �� � <br /> Electrica ontractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> �G' � -� <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: � � '�c�l, c�Ct h'i<</� <br /> ��� S i rv�i �C��rJ� U S��t� K-�i'V�a 1i�9�- (-Z�W,��- <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �,,� ��, <br /> ���� <br /> I hereby certify that l have read and examined this application and know the same fo 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 fo give authority to PERMTT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That 1 am authonzed by the owner of this property to perform the E � ��� '6t�� � �� <br /> work for which application is made and I comply with fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � �� �� ��-� <br /> i �n .n � �.�'� <br /> Si ature ' Date <br /> REVISED 08/O6/2014 <br />