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ELECTRIC�4L PERMI`T APPL�CATION <br />CITY OF EVERETT PERlVIIT SERVlCES <br />3200 CEDAR STREET, EVERE�ii�, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – www.evereitwa.org <br />� -- a�-�5 <br />� 1SD7-1 j!� <br />��o� � � <br />(l/�,s+�iz./lr�� �'i>'1- c�r>� l/�,�-17 �� � �� <br />PROJECTADDRESS �fLf6L� /�i Iy%jj� L� � <br />Owner <br />Tenant <br />C-ICLtfical <br />Mail Address <br />MailAddress <br />�it' l S � �� <br />Mail Address <br />��.���� �/i.��6 <br />Stale Licens umber (required) <br />�i�L ��>�.��= <br />Proposed Use ot Buiiding <br />Square Foolage (If residential new construction, remodel or addilion) <br />Gity <br />Gity <br />City <br />Sta�elZip <br />State/Zip <br />Stale2ip <br />F'hone <br />Phone <br />���13�" <br />Phonc <br />O� kJ'� <br />Cily o( Everett Business License Number (required) <br />700 _ <br />CoMracl Price of Work <br />Contad PersonlConlact NumbedEmail <br />Number o( devices pf low voltage) <br />� <br />Description of Work to Be Done: _��.i, ��% �' G��" `-' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cr,riily that f have read anJ examined (hi,^, applica(ion and know U�e samc fo be fnie and <br />correcf. All provisinns ollaws and ordinances goveming Ihis type ol work �vill6e conrplefed <br />whethcr specified hcrcin ornoL 7he gran(ing ol a permil dnes not pm.sume lo give au(honty ta <br />viola(e or cancel lhe provisions ol any othe� sfafe orlocal law re�ulalinr� consfrur,lion or fhe <br />pr,rlormance oI r.onsfn�r.fion. ihat I am au7horized by the owncrol(hi.^, pmperty �u pcilonn fhc <br />work for which applicalion is made and I cornply �vdh (he S(a(e Con(iar.(nrs Law 18.27 RCW and <br />�aF �nn wnr. <br />n,,vca n orvor✓toia <br />FEE <br />�3so <br />PERMITI/ <br />E � 5 a7 - f 50 <br />