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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 / 2`3 <br />425-257-8810 - FAX 425-257-8857 - www.everettitl <br />C-EjIU/Z-oZz <br />►Q JL , Su ; -421Jo <br />PROJECT ADDRESS <br />L-4 � t✓Tr w A . 9 �3 zv 1 <br />&:�� t� LA-LiA <br />317-u <br />l-1 <br />6 n q + t)!& <br />Z00 <br />CVOl <br />tll.-A <br />Owner <br />fil 1 ACCrecss <br />Cry <br />Sta;e2,p <br />Feone <br />j Rc? i L/1tU <br />— - <br />TeraTeractT— <br />Mad Address <br />Gty <br />Statef7o <br />Phone <br />P w dew ,c,+�'� <br />Ut z7a(o <br />WN—►fie_ S <br />- <br />kl CM31 <br />Electnca Contrac`or <br />Mail Al <br />Gry <br />State'7ip <br />Poore <br />State Lice -se Nu^tber (recu red) <br />2M Le - <br />Proposed Uske of Budding <br />3`1N43 <br />City of Everest Busiress License Number (requ red) <br />Contract Price of Work <br />Square Footage (If residential new constructor, re^edel or add,s:on) Contact PersonlCortact Nt.mce,,Email <br />Number of devices (if low voltage) <br />Ryey,�F�rc <br />DescnI�1psidn of Work to Be Done ' 'v C ` !-'T <br />-0 uC(e�S &)(,)K <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 i 1. 0_G <br />thereby cerl; y that I have read and examined this application and krow the same to be true and ,J <br />correct. All provisions of laws and ordinances governing this type of work i l be completed — <br />wheth, , ^0ecrhed herein or not The granting of a permit does not presume to give allthonty 10 PERMIT# <br />vio. / �)r cancel the provisions of any other state or local law regulat:ng construction or the <br />perl, race of co truchon. That I am authorized by the owner of this property to perform the E B I `-�- I Z 0ZZ <br />work for which ph ahon is made and I comply with the State Contractors Law 1 27 RCW and <br />296 200 WAC <br />REVISED Val Jlu <br />