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ELECTRICAL PERMIT APPLICATIDN <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 />�7�PLC���'k% t`�.lD�i,�Sll-�ot�i.� ��3(.�i,Y"� ��K/}Q��--� D�t�G, ����TT, �rih,, vj�20�} <br />PROJECT ADDRESS <br />'�U�Y�LiEiJ 5�l-kh?<,p�sT�2iGi ��'LS 1k��o�2T l�l��, ��P�YT, USA. q43�Lo%� �-t2S3Sb.tr�S� <br />Gwner Mail Address City State/Zip Phone I <br />M1,t�t,+-�i'i� sGLK7o V�7 t5 i�G�t' ti� l� <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: ��'�1.i� �ld�l1L:�Ci � 1�VS�CDd.L1� GDN17l� I"« YO'2 t'�'���� <br />z <br />�'��c���� f'D���� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming thrs type of work will be completed <br />whether specified herern 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 regulating construction or the <br />performance of construction. That I am authonzed hy the owner of this property to perform the <br />work for which application is made and ! comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />re <br />REVISED 3/20/?3 <br />, 2�, <br />Phone <br />FEE <br />���'�� <br />PERMIT# <br />E C � d� (� <br />