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� ��C� � V� � � C,��� �, � � -� .� �:�� � °-�-. <br />� _ � � � <br />E`LECTRIG,AL PERMIT APP�lCAT�01V <br />CITY OF �VERETT RERIUIlT SERVECES <br />3200 CEDAR STREET, �VERETT, WA 98201 <br />�125-257-881 Q - FAX 425�257-8857 = www_everettwa.gov <br />���� �c.�-Fe�(� �� <br />PF20JECT ADDRESS <br />��ra +-�'� f�'��?.� �� 0 7 �'cc.K-�i �r' � <br />�`�� �ivlail Address C3ry <br />Tenant <br />�� ��� <br />�lectricaf Contractor <br />Mail Address <br />�� � <br />Mail Address <br />�D�� �� ! � <br />State License Numbe.r (requir�d) <br />��� <br />Proposed Use of Huilding � � <br />City <br />�� ��� ���a� <br />Stafe/Zip <br />Sfate/ZPp <br />>� �!�l: iv � �Q.�� <br />Square Footage (If i�Sidenti8l new construCtion, remOdel 01" �dlilYioi�) <br />IVumber of d vices (lf low voltage) <br />Description of Woric ta Be Done� <br />CiTY �F EVER�TT LOCAL SALES TAX CODE IS 3i0g <br />c�y <br />SCa#e1Zip <br />�� <br />��O � ��^ <br />��.a� <br />Phonp <br />Phone <br />��s"a 1 <br />d �,�. <br />Phane <br />City of Everett Business Lice�se.Nurrtb�r (required) <br />f—�� �� , �� <br />Conttact Price of WOrk <br />�Q.�e�� �c.crt-�-�'i� ��.5 Sto� f 7'7 J <br />Gantact Person/Contaci ber/Email <br />rCY�'`l�'� T� �t',� t <br />l hereby Cg/tify fhaf / haVe reed ertd examined fhi3 appliCc�f��n r7nd know the same fo be true and <br />co�rect. A!! /�rovisions of Isws and ordinances govemrng tf�is type of v+�ork will be complstod <br />whefher spe�ed herein or not. The granting of a pemrit rloes not pr�sum� to give aufhoriiy to <br />v101ate ot' CaYtCel the provisrons of any other state nr lnr�l law rtegtd2fing construction or Fhe , <br />�rformance of consfruction. That 1 am authorrzed by rhe oWner of this property fo Qerform the <br />work foi whiCh epplication is made and l cornply wiin the Siaf� Confracfors Lsw 18.27 RCW and <br />296.200 WAC. <br />REVISED 08R7B12091 <br />F�E <br />��� �� <br />�� Il'D <br />pE RM iT# <br />E f ��c��f��q�3 <br />TaITO �Jbd �I�11�3�� �I�QN�� 998zz955Zb 5T �ZZ 9TaZI�Z/b0 <br />