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ELECT ICAL PERMIT AP011CATION <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 /> l 0 2p o 2F5t'" lire. SIF <br /> PROJECT ADDRESS <br /> F�c.r��t R bl:G Steals 4=� 3o C-1 4-LP- ev- e-4f <br /> Owner Mail Address City Stata/zip Phone <br /> I✓F eytlloww N��d(� 1c�2oot�. ,qvQ S� Ev�rc, w� 828 Tenant Mail Mail Address City State/Zip Phone <br /> r✓*Lt,,--A Cor.-•w. i ca i t vr..s �q52�/ S7-E- !: v 7 e 2.08 q 2`3-3Zf-53 .3 <br /> Etectrical Contractor Mail Address city State/Zip Phone <br /> State License Number Contract ice of Work <br /> Proposed Use of Building Contact Person (flan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> 215 <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined this application and know the same to be true and V <br /> correct All provisions 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 PERMIT# <br /> (violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That 1 am authorized by the owner of this property to perform the E � . r✓5� <br /> wont for which application is made and/comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> v�3 <br /> Sig ture Dat <br /> REVISED 3/20/93 <br />