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ELECTRICAL 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 a --2--4 I(, <br /> g ) O -172 <br /> Si 5 -. ectst rio Ra. . &'t-ee. 15 <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> srnlIts_ay.1,5l-- a itU?res 7)155 g' Gast n0 R &.'L e. t .vere,-1-1- 1&iA g82,08 <br /> Tenant Mail Address City State/Zip Phone <br /> 1 ,,T 5tgY1 .Jed CCS t 2JZ .13,4)10 l--Evetekl- f2,39 fl i 1L CRee1L V/A 1Z.f.33D,/9110c) <br /> r Electrical Contractor Mail Address CityState/Zip Phone <br /> l 86--- <br /> 15131-615 ci 9C' PQ <br /> State License Number Contract Price of Work <br /> Co rn 'nxx�c a1 , t)4 i-sti nc -r an V—, <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 816 61 * a) IP <br /> Square otage(If residential new construction,remodel or addition) ; <br /> 1ReuVer Sap9•11) <br /> Number of devices(If low voltage <br /> Description of Work to Be Done: 1 n s-ta l I Ler? f?V 1 $tg n a l&picul <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105. <br /> L. <br /> y <br /> I hereby certi4r that l have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed - - 'x <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 I am authorized by the owner of this property to perform the <br /> E t 02 X12 .1 <br /> work for which application is made and f comply with the State Contractors Law 18.27 RClil%and g <br /> 296.200 WAC. '' <br /> IE , li1 ®/ 22. 1 <br /> J <br /> gn e Date_ A <br /> f:3 <br />