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ELECTRICAL PERMIT APPLlCATION <br />C[TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />-- _-- _ _ _.... ------ <br />_ _- - - --- -- - -_ ---- -- -- - <br />f/ - ' --r- ---- - - - - <br />; ),�� ,,,J. �tilt'�z�:,��. U��=r„� y�i' <br />PRC?JECT ADQRESS <br />� <br />r; �'T V� �VGrCa� � <br />Owner Mail Address City State/Zip Phone <br />I �— I �(.' �' �V).'.'.1 H l�l�.L ��)L✓�i 'n?,�•:'i � �'r�J�V (n/� -( 15,�.7I ) -.Z�.L� %1 %'% 7 �`'j <br />Tenant Mail Address City State/Zip Phone <br />���kL �EL i�+� �4G�1 �k��;,��-64LL ��'e CV,�:24:tz- �„/tr- �iX�'i `1.1i'��"�-f�L�� <br />Electrical Contractor I✓�aii Address City StateiZip Phone <br />i��►���E � ��%� � <br />State License Number (required) <br />Proposeo Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />���L�� <br />Ciry of Everett Business License Number (r2quired) <br />�\JL/ �" �� <br />Contract Price of Work <br />�v�u S E�v�r�� 3t�� �L � t-t�S� t <br />�5��1.Ln.S �t�i.Jti� L! ���t^ ic_ . C 6 e�►h <br />Contact PersonlContact Number/Email <br />Description of Work to Be Done: �� M r° =-✓u-� i�'t-c � �!vN ��-f' V�G•,� <br />CITY OF EVERETT LOCAL SALES TAX CODE !S 3105 <br />1 hereby certrfy that I have read and examrned thrs application andknow the same to be frue and <br />correct. All provrsions of laws and ordinances governing fhis type of �n�ork will be completed <br />whether specrfied herein or not. The granting of a permri does not presume to grve authority to <br />vrolate or cance/ the provisions of any other state or loca! law regulating construcfron or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the 5tate Contractors Law 98.27 RCW and <br />296.200 WAC. <br />_.� � _ ,�.,, �i� / <br />� i <br />� � ��_...-_._�__ / % � � <br />REVISED 06/Ofi2074 <br />FEE <br />S�--56 <br />PERMIT# <br />E �c� �o — 6C� <br />