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ELECT CAL PERIlIIITAP ICATIaN <br />CITY QF EVERETT PERMIT SERVICES <br />3200 CEDAF� STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �i.t ti�v ��c�' -�� +���-��'�":�`�� ��'�� - ��a >` <br />��� - <br />� �-titi��. � ( ': � ��: r� ��.e � S �� � sie,r��-t=�' cn�E,�. . � � J <br />. �,,; <br />PROJECT ADDRESS <br />t 4� �, <br />Owner <br />Tenant <br />� n:-. <br />, o �,�,< < h��� <br />Mail Address <br />Gilti'1 tV i:) �" � E �°„ �;�I r�' i> <br />Mail Address <br />1:_��1��...�... <br />City <br />City <br />�., <br />�--v� / �' � �' � <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />'i � <br />�r �(�^.��t �y� {? �I.�ZZ�I� � L� �`b r; � jc �-{ � t.� !�i 1°�v'--i.��r� �� l,.? �. `�I i,' e L� ? ��-J 7 5, ��l Z- Zc� 1� <br />Electrical Contractor M a i l A d d r e s s C i t y 5 t a t e/ Z i p P hone <br />k�!J�'..��j�-s t, �� x- � j �`� i.�j �'�� � ��( <br />State License Number (required) City of Everett Business License NUmber (required) <br />� � ��� °� <br />i��' �� i �%�;'�:;,�� � <br />Proposed Use of Building Contract Price of Work <br />Square Footage (If residential new construction, remodel or add <br />umber of devices (If low volfage) <br />„�-.� - C�-t�, �'c� i.J i S' c- mo �;.; wr,. ^� ,v v,; �., N i� , �,� <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: CL�S����l-lL/ C?�i: ��,`y S��v i N � fl.c�`'U<�[:i}'v��7'v�- ���. ��Cr+7"c <br />/ <br />��'��r� �-;� �� s ; ��;� ti �>� r�:>ti> > - . , .� ; �; <br />ClTY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify fhat l have read and examined this application and know the same to 6e true and <br />carrect. A!I provrsions oflaws and ordinances governing this type of work will be complefed <br />whether speci�ed herern or not. The granfing of a permit does not presume to give authority ta <br />vio/ate or cancel the provisions of any other state o� local !aw �egulating constructron or the <br />performance of construcfion. Thaf l am authorized by the owner of this property to perform the <br />work for which application is made and l comply with the Sfate Contractors Law 98.27 RCW and <br />296.200 WAC, <br />nature <br />REVISED 08/O6/2019 `2 ( L � ��� � /�� e <br />f✓ �.J l i <br />FEE <br />� ��, �' <br />PERMIT# <br />E��Q� -a?�� <br />