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ELECTRIGAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wwv✓.everettwa.org <br />- ___ -- - --- - - - - -- -- - -- <br />� (�1,� � L U�u.G�i�r�� %�✓( <br />PRQ.lECT ADQRESS <br />N 1:,vLt:� L'►� LLS %G �!% LG�ln1✓'rd��?v.J '�U�z�eF: � W�� �l�h'.�G�d •���L - -��.t�` `'JGt;� <br />Owner tJiail Address City State!Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />��►�kt �ELTr?l.� ��tG�i �k���°,�-�h�� f�i6a� Elt�:��z- �,�1r CK�'i �f�S-`���-f�&x;� <br />Electrical Contractor Mail Address City 6.-S#ate7�ip "� Phone <br />C <br />�'�����E� ����� � � � t� � <br />State License Number (required) City f Everett Business��icense Number (required) <br />� �` <br />�,., <br />r�-�� S; dli�,vC.�; <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Co,/n�tract Price of Work <br />F 51��.i Si�iJlc(.ES .3(1E�'E.�� -f�S��► <br />dS��v�ws �.�E t[ ec�r �� .c��n� <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: � G a�' �-Y��. � � =� �-' �1����'� �� � � Yz �'� N � �— <br />��J f� <br />C(TY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />, <br />, .)t'a��44.�,-;,L ��i7V��� <br />I herebyceririy thaf 1 have read ana2xamrned this appiication and know ihe same-to be true and <br />correct. Ail provisions of lav✓s and ordinances goveming this type of �n>ork will be completed <br />whefher specifred herein or not. The granfing of a permit does nof presume to give authority to <br />violate or cancel the provisions of any other sfate or local !aw regulafing construction or the <br />performance of construcfion. Thaf ! am authorrzed by the owner of tl�is property to perform the <br />work for whrch applicafion rs made and I comply wifh the State Contractors Law i 8.27 RCW and <br />296.200 WACs� , I � <br />I��. �ti,. <br />ure <br />REVISED OB/O6/2074 <br />�1 _ �� ( ` <br />�.- <br />uate <br />FEE <br />� O� � <br />� <br />PERMIT# <br />E �C�D ( -- �� <br />