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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 <br />i� 1� Iv1'� P�. 5��- <br />PROJECT ADDRESS <br />�; �� � 12�'Z e l � �. <br />Owner <br />Tenant <br />iX"�1�t'vC �\Ec�iC <br />Elec It acir Contractor <br />��L�IC��i���I�1 <br />State License Number <br />Proposed Use of Building <br />�i` !i.'��\ f'�I �l/.� <br />Mail Address <br />Mail Address <br />��� � <br />Mail Address <br />L1. r� �,��- <br />C ity <br />City <br />� <br />� Sjc� ' �., c. �l <br />City <br />Z�� <br />Square Footage (If r sidential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />� �f 1�-�� iJh s'� 3�= �' S�, <br />State/Zip Phone <br />%C�J��. ��� <br />Contract Price of V�,'ork <br />l'i%� s ��� �� �CeS <br />Contact Person (Plan Review) <br />- ,� <br />Description of Work to Be Done: l"{U�� j�� l-i,y — jyr� �� e"�,��:z�,;`�� �c���;�,� �-�?'�iv a*�y. ��'� ��� /� 3c�n��:y, <br />� <br />���a�a.L'� CL�1 �\f'��3 C��i�Ckj � - ��_���, ��,��5 ��vt�li..�I��C 5������4��� cY.t��'vS �� r�'v�t����c � -�".� <br />�J�a'v' ;�C'�. r„�� '�����ae,e Cp- !"CG�� � - <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that l have read and examined this application and know fhe same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume fo 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 authorized by the owner of this property to perform the <br />work for which application is made and I comply with the Stafe Contractors Law 18.27 RCW and <br />296. 200 WAC. , i <br />�� <br />f%% �C���._�/� <br />Sie%ature <br />REVISED 3/20/73 <br />FEE <br />y r. � <br />�> U <br />PERMIT# <br />E13���-�oj <br />