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� <br />n <br />�� <br />E:I_ECTRICAL PERMIT i4P'PLICATIOIV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />i ( o � sE �vrr�� ��r W�-Y <br />PRO.JECT ADDRESS <br />In ) AG ��-T <br />Owner Mail Address C�ty <br />Tenant <br />Mail Address <br />Cily <br />ES Z�£�S (I(�fl� S-f:G��C. , <br />Electrical Conlractor MailAddress <br />GO(lf VDI/G �iS�? <br />State License Number <br />Proposed Use of Building <br />qo,voo <br />Square Footage (If residential new conslruction, remodei or addition) <br />i�� <br />Number of devices (If low vol�age) <br />Ci�y <br />SlalelZip <br />SlatelZip <br />� <br />C�act Price of Work <br />Phone <br />Phone <br />�� � <br />s�s-�v_L <br />Phone <br />Contact Person (Plan Review) <br />Description af Work to Be Done: CG I� �YSTEM F�ELu/�-/ 7� !}L+9��^ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />! hereby ceRi(y that I have read and examined fhis applicafion and know (he same to be true and <br />ca�ect. All p�ovisions o/laws and ordinances goveming this fype o(work will be completed <br />whetherspecilied heiein ornof. The granting o/a permif does not presume (o give authonty to <br />violafe o� cancel Ihe provrsions of any ofher sta�e orlocal law regulating construclion or the <br />perfoimance of construcfion. Thaf ! am authorized by Ihe owner of fhis properfy �o peAorm lhe <br />work (or which applicafion is made and 1 comply wi(h the Stafe Con�ractor< Law 18.27 RCW and <br />oor, onn iniec <br />FEE <br />�� S�o <br />PERMIT# <br />E ��os-tsg <br />