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�� <br />� <br />ELECTf�iCAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� <br />� � j � � �„i•, �� � -' ��/'� <br />PROJECT ADDRESS �y ./ <br />��\ � �4/4���� / ,I/� <br />l <br />Owner <br />Tenant <br />� <br />L; � lt�ni �';'� � � LfJ//Y <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />!� �/e1��' l/ <br />City <br />City <br />� ��� � f�s.1 �°,,,�1: <br />� 7 L-. <br />Mail Address City <br />� !��'��� orJ %'�"�" l `�/l�r <br />,State License Number <br />/' � �C��«� � / <br />,�`�v'L /�' �Cf+.i� � �� S� i <br />Propose Use of Building <br />`�'��� ���i G ��' � <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />���,� c�=l�T��' ,�,���.� � > <br />� <br />� � r:'�' ZS =� %: � �`�; <br />State/Zip Phone <br />, /J / ��cC� <br />`� --/ <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />� c�= � 05< �5 z_ <br />/� , �'/-�e- ,[._ <br />� / 1�`L�//�C��✓� �M� r�" s'c� �?sl r_ C/ <br />Number of devices (If low voltage) <br />D"escription of Work to Be Done: <br />�'��-.�� � ���� << _ <br />�� ����, ��l`�� � �/1r-,•,�:���«f' <br />��c✓ Z �C�L.��� liC%�f ��� �f./i�.�1J`c � GO�t vi � <br />J�t'�i"�'�� �.l.e-r!'- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />,�/-%,/^�' `'` � <br />.z'- jE���1/ <br />� ,,.� �«: <br />� 1,��- �,�/,► �n �'�'��' <br />� <br />1 hereby certify that I have read and examined this appfication and k�ow the same to be true and <br />correct. All provisrons of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law �gulating construction or the <br />performance of construction. That 1 am aufhorized by the owner of this property to perfo►m the <br />work for whi application i d nd ! comply wrth the State Contractors Law 18.27 RCW and <br />296. ��' ��. s�— � J <br />� ./�jtie�� ��ry /� `i� <br />/ � � � L �7 <br />/ r�_a,. <br />gnature <br />REVISED 3/20/73 <br />FEE � <br />5�.�.i <br />PERMIT# <br />E �5 0 �— ��'� <br />