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l.J <br />� <br />ELECTRICAL PERMii APPL�CATIOh� <br />CITY OF EVEaE�"T PERMIT SERVICES <br />3200 CEDAR STR�ET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetiwa.org <br />��05" S� E�����I M��r r,✓.�� <br />PROJECTADDRESS <br />lniAL�lL7' <br />Owfler MailAddress City StatelZip Phone <br />Tenant <br />Mail Address <br />� � Se.GLiY <br />Eleciricai Conlrec�or � Mail Address <br />� v�� �/ ��/ S � SS 02 _ <br />Slale Lir.ense Number <br />Proposed Use of Building <br />9� o�fl- <br />Squ re Footage (If residenlial new construction, remodel or addilion) <br />Numher of devices (If low volfage) <br />Description of Work to Be Done: �r�t.r' ,¢�A✓LM S�YS fENf <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />City <br />SlalelZip Phone <br />Slale/Zip <br />�t«'°, <br />Contracl Price of Work <br />Contact Person (Pian Review) <br />1 hereby ceRify fhat I have read and examined this applicafion and know fhe same fo b�� frue and <br />comecf. All provisions of laws and ordinances goveming fhis fype ol work will be completed <br />whether specilied herein ornot. The granting of a permif does not presume fo give authonty �o <br />violate orcancel Ihe provisions of any otherstate oilocallaw regulating construcfion oi the <br />peiformance of construc(ion. That ! am authonzed 6y fhe owner o/ Ihis property lo peito�:m (he <br />work (or which application is made and I comply with �he S(ate Confiactors Law 18.27 RCbV and <br />oo� �nn miac <br />Phone <br />FEE <br />�da� <br />PERMIT# <br />E1�i05-�(p� <br />