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� <br />ELECiRICAL PERIVIiT° APPLICAT'iOfV <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 />� �l1 - � <br />, � ` <br />�. . . �,�= � � <br />_ �-1 ___ — <br />' ��-- `{ �__ � _ _ _ � <br />%`��ZD � � N/f��C 1A%� ��G1%%,�_/��— <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />StatelZip <br />State/Zip <br />Phone <br />Phone <br />I IZ�- /'V l ��G�/G 3� o� lU� l 7'�Gl ���r"s %��� g�/� �" <br />Electrical Contractor Mail Address City State/zip Phone <br />�Zi" 7�3-y6? 7 <br />l k'.�Nr.��� 58�� <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />�f�� �-� � '-� �� <br />City of Everett Business License Number (required) <br />�3�aG� ' <br />Contract Price of Work <br />����,C"� �� � Z5 �? 3 -�6 7 <br />Contact Person/Contact Number/Email <br />-�'ri •�'rt. e%�ri ��✓✓A�n �`lev�.�oy <br />Description of Work to Be Done: ..Y/t/�t11�7 / /�'L�i � �0 ` (i� � I' ���%��/�i'�7 <br />Co��� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />* <br />1 hereby certify that l have read and examined this applicafion and know the same to be true and <br />correct. All provisions oflaws and ordinances goveming this type of work will be complefed <br />whether specifred herein or not. The granting of a permif does not presume to give authorify to <br />violate or cancel the provisions of any other state or local law regulating construcfion or the <br />performance of construction. Thaf 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the Stafe Confractors Law 18.27 RCW and <br />�na onn inin r� <br />FEE <br />I �J�j ��� �' <br />PERMIT# <br />E ��� c f .. ���� <br />