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� � <br /> ELEC'fRICAIL IPERMIT �APPLOCA�oO(V <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> �jf�C1 ��oi�r ��c <br /> PROJECTADDRESS <br /> Gc1.ro1 Qa;le,/__ fs14 R�oi� dl� �vcce�i- � � �IZS ZGs �►ZS <br /> OWner 7 A1aAAddress Gty Slale/bp Phone <br /> Tenant 61adAdd�ess Crty StatelZ�p Pnone <br /> ��,a��C�n r►����;� s��G �GH4" '� n� �ue�e�4- �,� A yz�ayyssn <br /> Electrical Contractor A1an Address C�ry SlaleiZ�p Pha^e <br /> S�� �c�l 9�oPk U5�57 <br /> Stalc+License Number(required) G�y ol Everell Business License Number(reqwred) <br /> Proposed Use of�wld�ny Canlract Pnce of Work <br /> Squaie Footage (If residenlial new construction, remodel or adddion) Contacl Person/Conlact Number/EmaA <br /> Number ol devices(If low voltage) <br /> Description ot Work to Be Uone: �'�� �—G��--1-�-�TS _�1� ��. _--��_ <br /> �---- <br /> --�-��1���hc�����.�s <br /> FE� �� O� —��._ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 � <br /> I hereby cert�ly tliat I have read and examined fhis applicafion and know fhe same fo be fruo and <br /> correcf. All provlsions ollaws and ordinances goveming fhis fype ol work wdl be complefed <br /> �vhether specified heiein or nof. The granfrng ol a permd does not presume to give aufhonty fo pERMITN <br /> violate or cancel fhe prowsions ol any ofher stato orlocallaw regula6ng consfrucfion orlhe E �5 0 3- 03 D <br /> peAormance o!construction lhaf I am aulhonred by Ihe owner ol fhis property fo perform fhe <br /> wo�N lor which appli ' i is ma e and 1 comply wifh Iho Sfale Contiacfors Laiv iB27 RC W and <br /> 296200 WAC. <br /> � 3-5- 2ols <br /> 9gnalu Dale <br />