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� <br />ELECTRICAL PERIVIIT APPL.ICATION <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 />��1� n�{������-� <br />PROJECT ADDRESS <br />�f� <br />Owner <br />= �T <br />Tenant <br />� <br />__j G-.hn,2. <br />Mail Address <br />,�� <br />Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />�'�� �c�,tiJ:n.�_ti�.Jti.� 3l�'�� ''.�l'1'v/7 _�h�/t� �Z(' ��,/�� c�41�-L'� �6.0/�.�_���� `� <br />Electfical Contractor Mail Address City State/Zip Phone <br />' i - � `J <br />�rL �� U <br />State License Number <br />/� � / <br />�-j/�. �n..V�,�i- .�n _� 1"�:J-�C'.a�n,C°ii-.. S� i�,t� �� <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />j v <br />Number of devices (If low voltage) <br />Description of Work to Be Done: `;.ti��:�-!' V�' �-'�-- ��^-�rl <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />��\\ <br />/ C� ['_. <br />_�� /�.c�Z� . °�.� <br />Contract Price of Work <br />, <br />_�'} .�_ .� ., l /� ^-r� L� �- <br />Contact Person (Plan Review) <br />C ��. <br />I hereby certify that I have read and examined this application and know the same fo be true and <br />correct. All provisions of laws and ordinances governing tl�is type of work will be completed <br />whether specified herein ornot. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other stafe or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this properfy to perform the <br />work for which application is made and I comply with the Sfate Confractors Law 18.27 RCW and <br />296.200 W,4C. <br />FEE <br />�� �� � � <br />PERMIT# <br />E 1�0�-�C� <br />