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• <br />� <br />�EL�C7"RIC,�4L PE�MpT APPLICA,"��14�1 <br />���� oF �v����rr ����rr s��v��Es <br />320Q C�DAFZ STRE�T, EVER�TT, WA 98201 <br />425-257-881Q - FAX 425�257�8857 — wvvw_everettuva.org <br />�p.� D C� ��c�Z� � �� � � -' `� � I. ..� <br />�� ��, � , <br />PR0,IECT AbpR�SS <br />� , �� 1�'C <br />Owner <br />��'i�'N `C� <br />Tenant <br />� <br />2 C��4Z �i�4ln� ��°-�C,C2�i <br />�lectrica! Contractor <br />�� �n V�.����'� � 1 <br />Mail Address <br />Mdi! Address <br />��1 <br />City <br />Clty <br />i�-�- 1� c�6 �,�>L— (% ��Z(� ? <br />—�_.,_ � <br />State/Z � �, Phone <br />'��� �y � S.�SS <br />l �'�' � I S� �t�� S'o.�l"�' < <br />I AtldreSS <br />� A��5S23�1�� <br />State Lic�nse Numb�r <br />Propo;ed Use of Building <br />t��v / <br />Squaro Footage (If residentlal new construction, remode! or additio�) <br />V <br />Number oF devices (If low voltage) <br />Description of Work to Be Done� ���\��``�J/C.,�.r-� <br />� , . <br />CIiY OF EV�RETi �pCAL SAL�S TAX COpE IS 3105 <br />l her�+by certffy that l hr�ve <br />�a�ect. AlI provisions of � <br />whother speclFr�d her R <br />viol3to or cancel th 1; <br />P���ance of c sf ctk <br />worir for which e pi atian <br />296.2D0.1�'f,ds-� <br />4Pvlse� ,�a�3 <br />Gity <br />State2�, � <br />/� <br />Phone <br />�b��5rare/Zf��' Phonc <br />�Y � s �:_ � z. <br />�o�c:} `� <br />Contract Price o� UUork <br />� <br />��� �����C <br />Contact f�erson ,'�'lan Revlew) <br />rap snd examined this sppllcation �nd know fhe same t,o be tn�e snd <br />vs and o�;n� ��, gov�minq thrs type of work wi11 bo completed <br />nol. The nf ,q of a permit does not pr�sume io gi��� authorfty to <br />7ns of a otho sratQ or bcal law r�gulafing constrr,�ctforr or thc <br />. That am au hor�2ed t�y the owner of #his property to �erform the <br />mad and i c mply �n�fth thc SfatQ Contracfors Lew 9b.2i RCW �nd <br />/ <br />�l �� � l � <br />FEE .. <br />�� �`' <br />P�RM-r�-�� <br />EI�{C��'-��� <br />