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11-Oa-fa.Ot-.�7CL1. <br />20G30J2900 tt t! t <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVER[TT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —uvww.everettwa.org <br />'� 3 a Z �Z..���- Av� <br />PROJECT ADDRESS <br />I l �05 -GV <br />c-���i��f0 <br />� C—�-�'c� L!-C.. 5Zo P; �s� s...,;�� �sos 5�,�1�ju/,g-9�ro� - <br />Owner ldail AdCress Ciry Stalc2ip Phone <br />�� <br />Tenant <br />Electncal Contractar <br />hlaii AdCwss <br />wr.� c�'rC7 <br />Mail Address <br />�LLI°�-�G�5-Oa6 i,- � <br />State Liccnse Number (required) <br />y�t.'i��� � <br />Proposed Use of Ovilding <br />it3aZ IZ...zk-�'/�J� <br />.�A ���3 <br />SWle/Zip <br />w,�i �8t3z <br />SIatMZlp <br />Phone <br />L�) 363� <br />� Z_L�� <br />Cily of Everett Business License Number (requlred) <br />� Z���70c� _ <br />Contracl Pnce of Work <br />% �Z� I� �w��,� C���b3-3to� <br />Square Footage (if residenlial new construdion, remodel or addit�on) Contact Person/ onlacl NumbedEmail <br />� O V^1��..�ci-�\v1�S�¢GDM.CO <br />r <br />Number ol devices (If iow vollage) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I ho�oby ccrlily Ihat I havo raod and r�xaminod fhis oppllcatlon and know fhe samo !o be fruo and <br />con�cl. All provisions o/laws and ordinonces goveming fhis rype ol work will Gu cornplofed <br />whofher spoci��d heic/n or noL T"hv granling ol a ponnif does not presumo !o give aulhaity lo <br />violafa or cancel Ihe p�ovisions o! any ofhor sfale or local law �ogulalinp conslruchan or fho <br />performanr.c ol consWclion. ihal l am au;honred by !he owner o/ fhis property fo perform fhe <br />wnrk lor which applicalron is made and I comply wilh !hu Sfatc Confracfors l.aw 78 27 RCW and <br />HEVISf' fN6?O�a <br />FEE � � <br />O� <br />P[RMR# <br />E (y-�r- o�c <br />