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� � <br />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 />,- l� �v�r� l�/� <br />PROJECTADDRESS <br />Owncr <br />�dad Address <br />C�Iy <br />1 eno�t n�a�,i Address C�ry <br />� 3 3 0� �3oTb>// E��rrT <br />��e� G-C/�c J-� % C H. l� ni'1a �s _ , <br />Elecvical CoMractor 6tar nodres ��.ty <br />I �/Z��n %T 9s'1 /zT <br />State L�cense Number (reqwred) <br />/����/>�i�/ <br />Proposed Use of �wlding <br />Square Footage pf res�dendal new cr,nstrucbon, remodel or addi6on) <br />Number o( dev�ces (I( lo�v vottage) <br />State2p <br />Stale2ip <br />Sta!e!Zip <br />PhO�[ <br />Phone <br />�.z3I- <br />TS G/7l <br />Phcn� <br />_ "=! /�l 1� UJ <br />Ciry of Everett Bus�ness L�cense Number �required) <br />700 <br />Conlract Pnce of Work <br />Coc!act PersorvComatl NumbmiEmail <br />Description o� Work to He Done _��/q/Y__�Q�yJq� 7�_.._�� / <br />_`._7. - <br />CITY OF EVERETT LOCAL SALES TAX COD[ IS J105 <br />1 hereby cnrtity lhnt I h��ve �ead and exarnrned (his �ppllcation and kno�v (hn same to br, frue und <br />correcl. All prowsions ollaivs ,+nd oNinances goveming tlus type o��vork wtll be cornplefed <br />�-;hefher speuGed hercrn o� nof !hc granhng ol n pennd does nol p�esume fo give aulhonty to <br />viola(e oi cancel fhe prows�ons o/ any other stale oi local law regulafing construchon or the <br />perlunnance o! consfrucGon lhaf 1 anr auRionzed Gy the o�vner ol thrs property fo peAc�m the <br />�vodr !or �vhich appl�Cafron is made and 1 conipty �vith the Stafe Confraclors La�v 78.27 RCW and <br />��� ��� �.,�� <br />nEe9sED a9 n W 0 i J <br />FEE --- — _-- <br />��� �� <br />EP RMIT# -- <br />E 1� D(o� nZC� <br />