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EILE�CTRICAL P�RM�� AP�LICA,TtOIN <br />PROJECT ADDRE5S <br />� � �� <br />Owner <br />4'�. ^ <br />fii <br />Tenan� <br />CiTY O� EV�RETT PERM17 SE�VICES <br />3200 C�DAR STREET, EV�RETT, WA 982�1 <br />425-257-8810 - �AX 425-257-8$57 ^ www,everettwa.org <br />1 ��- ���3 <br />�Q�� �1�����. �e. <br />Ma,il Address ���Y <br />MaflAddre9s � City <br />�� _ _ <br />�� � � �- � <br />st�farz�� <br />State/zip <br />Phone <br />I'hone <br />�Q �.�.C,���� ��'D.17 � 1�D� �%�� ��� `��� �4� �5 5"�� <br />Electrical Contractor Mai1 Address Clty StatefZip Phone <br />P�� �.�D��55 <br />State L[eense Number (required) <br />��� <br />Proposed Use of 6uilding <br />�/ . <br />Square Fo ta�e (If resldential new constructfon, r�model or addition) <br />Number of devices (if low voitage) <br />Description of W�rk to Be Done: �i�t�r <br />Cl7Y OF EVER�T7 LOCAL SALES TAX CDI�E IS 31Q5 <br />�[/ —I. U c?C,� - <br />City of �veretf �uslness�k.icense [dumber (required) <br />�' � �-� --� <br />ContraC# Price of V'Vork <br />Contact PersonJCont�ct Number/ mai[ <br />1 her•eby cerfify fhst I have rvad and examined thls applicaflon and knoW ff�e same fo be frue and <br />correct. A!! provlslons of laws and ordirrances goveming'fhls type of wo��C wrll be completad <br />whether speclNed herein or not The granting of a permlf does not presume to gfve authority to <br />vro/ate arcaneel tho provlslons of sny otherstafe or loca! law regulating construc�on or tl�a <br />psrforma��ce of canstructlon. ihat I Rm authorized by ihe ov�ner of this proAerfy to parfvrm fhe <br />yvo�}c for which appllcation is made end l cor»ply with the Stete Coniracfors Law 95.27 RCW and <br />99fi. �d0 WAC <br />Revrs�� oeiosizora <br />F�� <br />, �^�� �� <br />� JV o <br />P�RMIT# <br />E � � �Z� ���, <br />