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� <br />ELECiF�IC,�►L PEI�IV[�T APPL��r4`T��N <br />CITY O� �VERETT P�RM1� SERVICES <br />3200 CEDAR STR�E7, EVERETT, WA 93201 <br />425-2�7-3810 - FAX 42�-2�7-8$57 — www.everettwa,org <br />C� 3 7� C,a�.b � <br />PROJ�CT ADdRESS <br />� ►� SEh-} t.�� ��.3 %� c�� �-f �- �t/��-.r� � �' `� $ �-� 3 `�zs^ ,� }�� �%5 �- � � <br />0\vne� Mail Addresa City State/Zi� Phone <br />� t. <br />Tenanf <br />Mail Address <br />City <br />State/Zf� <br />Phone <br />. � �z� � <br />�� �� �� -�,����c 1 a�3 �z�.� �..s � ��� �1 �K� � s� � � <br />�lec�r9cal Contractor Mail AddrBas City State�Xip Phone <br />�U��t�-�' `��S 5' <br />State License Nun�ber (required) <br />c.� �� <br />Proposed Use af Buifding <br />� - <br />Square �ootago (ff residential new Cot�struction, remodef'or addition) <br />� <br />Number of devices (If low'volfage) <br />�� V� $Z-� <br />City of Everett �usiness License Number (required) <br />Contract Price o# Work <br />����.1 <br />Con3ac� persan/CotltaGt NUmbQr/�maii <br />� W �bs� �lt� <br />Descripfion of Work #� �e Avne; � ����� �-►3 � ���s -� � (J7�.JIt'���� _, ��C <br />�' �� <br />� <br />C1TY OF �VERETT LOCAL SALES iAX CODE IS 3905 <br />I hereby cerfify fhst ! have rnad and examirred fhis epplTcation ��nd {<now the ssme to be frue and <br />correct. All provlslons of faws and ordinances yoveminc� this type of work �ti�rl1 be cornpleted <br />ufiefher speclfled i�ereln or i�ot. The grsnfing oF s permit does not presume to glve Acrthority to <br />violafe or esncel the provisions af any ofher stste or loca! la��v ragulafing construction or ti�e <br />performsnee of construetion. Thaf ! am aufhonzed by tho awner af Fhls property to perfom� the <br />waifs f�r which appfication is made end ! camp/y wifh the S�'eie Contr�ctors Law 98.27 RCW and <br />296.�00 WAC. <br />.y <br />��vrseo oa�UFrzor� <br />��-�.�1�'' <br />FEE �(1 <br />� � f <br />� <br />PERMIT� <br />� l � 12� i (�� <br />