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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 425-257-8657 —www.everettwa.org <br /> ; z��-3-�y <br /> G �Uiz--/�� <br /> Z7z5 (�`��r�.� Av� <br /> PROJECT ADDRESS �r <br /> ,J � ' �v..t +-� /��vt.��t <br /> c�,-,.�� e <br /> Owner tda�l Address Clty Slale2�p Phone <br /> I--Y V-t/� �' pi✓ �---P-t. 5' 1✓�s7 l e�.N+�tL _ <br /> Tenanl Ida�l Addicss City Statc/Zip q Phone <br /> / /�Or � � / <br /> A-vi�n ww.l„_. �00,2 � (Oc !-t Gzi s.� 9 N� /�h.� Sfa,.�--� <br /> FleclricalContraclor MaitAddress Cdy State/l�p o�a75(b Phone <br /> /��r��nD�T 44S�h. � `r9 Zi� <br /> Slate License Number (required) Ciry of Everelt Business License Number(requrted) <br /> Proposed Use ol Bwldin� Conlracl Price o(Work <br /> �l� `^-Ini�� <br /> Square Foolage Qt residen6al new construction, remodel or addition) Conlact PersonlConlact NumbedEmail <br /> � <br /> Nuniber ol devices Q(low voltage) <br /> � � � � ,!�� <br /> Desciiption o(Wark to(3e Donc. ___/ `}'�__ ��.l,{Js'�L"tr�n� ' <br /> U <br /> F[E <br /> CITY OF EVERETT LOCAL SAlES TAX CODE IS 7105 ���O <br /> 1 he/eGy cmlily thaf I hnve reaJ and examineU(his opplic�rtiun and knov�the same fo Le true and — <br /> conec(. AO provisions o/laws and ordinances yovem�ng fbrs lype ol w.ork�•nll be complefed —� <br /> whclhr,rspr,cificd herein ornnL Thc granling o/a penruf dnes nof presurne ro grve aufhonty lo PERMCiI! <br /> violate or cancel fhe provisions ol�ny othe�sfafr. or loc��l la�v�egulahng constnicfion or fhe � I � I�/ I r � <br /> perforrnnncr, o/conshur.fion. 7hat I am aufhonzed by Ihc o��mcr o/lhis praperty lo pc�form fhc J <br /> work lor which applicafion is made and I corrrply�vdh(he SL�fe Conlraclors Law 78.27 RCW and _ <br /> 296200 WAC. <br /> -- Si9n�lurc���— Uale - �'�� <br /> PtVrSLUOBV�✓IOii _ __ ___' _ _ 1 <br />