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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425257-8857—�vww.everettwa.org <br />1����s � Even�"�a�� �c%ai <br />PROJECT ADDRESS <br />�l�o.���.^r� S�oreS �c. �U Uox 804 U l3vn�o� url�e R� "i2-I�2 4 7�•2oY�23zS <br />Owner Mail Addre55 City StatelZip Phone <br />A` <br />Tenant <br />Mail Address <br />Ci�y <br />StatelZip Phone <br />11P[.Tn N°r��iweSt' -12-7 S, aln`" 5�, SQG�-�i�e t�A qg��$ 2cite-rez5.3co�. <br />Electrical Conlractor Mail Address Cily SlalelZip Phone <br />Nea /,1T9�� :,� <br />State License Number <br />. 19/11 nS�a�l(;�'�'�o�^- <br />Pro osed Use of euilding <br />�liA <br />Square Footage (I( residential new conslruclion, remodel or addition) <br />rS <br />Numher of devices (I( low voltage) <br />��(0. �o <br />Contract Price of Work <br />;��. F�so�..-(sa��y���y55s <br />Contact Person (Plan Review) <br />DescriplionofWorktoBeDone: l 1�14•��� �a�� j'�U�"�k4{CO $iy.�5 "�' zX•SC��'^5 (:1�'Lu� r5_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I here6y certily fhaf 1 have 2ac' and examined fhis application and know fhe same to be true and <br />correct. All provisions ollaws and ordinances gaveming this type ol work will be completed <br />whether specified herein ornof. The granting ola permit does not presume fo give authodty to <br />violate or cancel the provisions o/any otherstate or7ocallaw regulating construction or the <br />per/ormance of construcfion. Thaf f am authorized 6y the owner o/this property fo peAorm the <br />work (or which application is made and 1 comply wifh the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />REVISED.VINIJ <br />FEE <br />✓d � <br />PERMIT# <br />E I�fo�- i�� <br />