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ELECT�CAL <br />PERIIIIIT AP ICATIt�N <br />CITY �F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -- �.� zv �.c� ��" +•'�-��«�"�' �v'��� . �,,�� ,.�" <br />,, <br />''� lti1�� i � . G' il L J�/ `�' `� �e �' S � !G. V�'�s'ti�"-`p' ;1 ����2 . w'� ;� �� �` � <br />�...j <br />�Niry <br />�=. .,. �w„ '� , ..[�"��. <br />PROJECT ADDRESS <br />Owner <br />��a ����� � h��j � <br />Mail Address <br />Gli.'vbN!�V t� I,l� (i;���''� �. <br />Tenant Mail Address <br />C �e��,G-�T <br />City <br />City <br />L-�a� <br />`(� %�d <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />'f u� l.t±�i� 1.,L l.� y i v �, i. ��� I�., f C r`� 6 � L �t !� �, � t� �;� �.., <br />x `� � ! � � r--t� ����,> �..: � . i v t� �� .� ( �-, � � ) ���� z - z�, � Z <br />� <br />Electrical Contractor Mail Address City StatelZip Phone <br />� i <br />� <br />t`f� L jU �'� � t� .�j t`� �< � � f�- (: `'l <br />5tate License Number (required) City of Everett Business License Number (required) <br />i� � �� �'i �'';1.� 7"�'� �"' '�i 1�`irA e � � <br />l�`"v� �1! <br />Proposed Use �f Builtling Contract Price of Work <br />Square Footage (If residential new construction, remodel or addition) <br />��� <br />Number of devices (If low voltage) <br />� C'-� �'c-%� p.3 T;S c• - itiw 9,.; �+r� �,� �,.; �-i�vv , t <br />Contact PersoNContact Number/Email <br />Description of Work to Be Done: C�Sj�""��G/_C_�`��;.�,'y S-'�V i N� ia �-�<�'�-,�:��-Lyv� �.��-�_ 4;� �. iC;�i�'"c � <br />� <br />r <br />� `�i�`�J', 4=,�� �s > i ��f� �v �:>�� �-t:7ti `) � , ; � ��' � � �. t G a,, ,,. <br />� <br />CITY OF EVERE7'1' LOCAL SALES TAX CODE IS 3105 <br />l hereby certify that ! have �ead and examined this application and know fhe same to be true and <br />correct. A!! provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give aufhority to <br />vrolate or cancel the provisions of any other stafe orlocal law regu/afrng construction or the <br />performance of construction. That l am authorized by the owner of this property to perform the <br />work for wl7ich application is made and l comply with the Sfate Contractors Law 98.27 RCW and <br />296.200 WAC. <br />, ������ � <br />Signature �� <br />i <br />REVlSED 08/O6/207•4 <br />P � L L �l ) /�= f-,� <br />�. � �: � ' �:� <br />FEE <br />� `�� �� <br />, <br />PERMIT# <br />Ei�D�-a�� <br />