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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREGT, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �^✓�+nv.everettwa.org <br />��`iCl 1�� o�..��.�Ay C�Jr:J`e-fi�-.t�(� <br />i <br />PROJECTADDRESS <br />Owner <br />Tenanl <br />Mail Addrese <br />G ✓�o < <br />Mail <br />City <br />crcy <br />Sta:e/Zip <br />a�a�e�up <br />Phone <br />f��� t- nr�n�rv� �IPc�R« �G �ox'-I2z Q�w�v� c,�;r1 �'g`>�G ?s3z�1 z <br />' Slate/Zi Phone <br />EledricalConlradOr MailAddre:a City P <br />f) � T� rz�r�� Y�� 1 C�✓�- <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addilion) <br />Number oi devices (I( low vollage) <br />�' A�o.vd <br />Contract Price o( Work <br />Contact Person (Plan Review) <br />Description of Work fo Be Done: G�� HT� N�^' ��'� +�� ���'�`` � L��� � � s, <br />Guoi��2 L(� 0� S <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3706 <br />I hereby certily tDat 1 have read and examined this application and know fhe same to bo true and <br />cormcf. All provisions o/Izws and ordinances yovemin;7 fliis type ol work tvill be completed <br />whelher speci�ed heiein ornot The granfing ol a perrrit does not presume to give authonty to <br />vro/ato or cancel tha pravisions ol any other state or local iaw regulating constructron or fho <br />peAormance o/construcfion. That 1 am authonzed by the ownero/(his property "o perfonn the <br />viork lor which application is made and I comply with tt e Stato Contractors Law � 13.27 RCW and <br />296.200 WAC. <br />L�_Z -I"� <br />�;[V6E`D LPYq <br />FEE <br />, <br />� Gj�• C� <br />PEF.�11T# <br />E � ��c �I - o � � <br />