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ELECTRICAL PERMI�' APPLICATION <br />CI�Y OF EVERETT P�RMIT SERVlCES <br />3200 CEDAR STREET, EVER�TT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetiwa.org <br />���Z !.� .(�/'ac�c-��.-% <br />PRO.IECT ADDRESS <br />6 ����y <br />�1 yob..o46 <br />�l�-� f S� ��c ��e , t� e...eGP �-��- —.�,�s fss yyyU <br />Owner MailAddress Cily SlatclZiF Fhone <br />Tenan� <br />67ad Address <br />City <br />Stalel7ip <br />Phone <br />(� S J �(e aS ' ,zoll 7.� S'` Sf ��-f1 w.0- 5�� 4��s .�s S3y 1 <br />Fledrical CoMraclor MallAddress Ci1y State/Zip Phone <br />�5,� L �c- �- d .G37_ <br />Sta�e License Number <br />S�� o <br />Prap seo d Use o( Ouilding <br />Square Footage (I( residentiai new construction, remodel or addilicn) <br />Number ol devices (If low vollage) <br />Desaiptwn of Wark to Be Done: %�+��' �0 4�a Cc��.... o.•e ��u� <br />CITY OF EVERLTT LOCAL SALES TAX CODE IS 3105 <br />'� f�Gc. <br />Conlrac� Price oi Work <br />Conlact Person (1'lan Reviee�) <br />I hereby certily fha� I have rnad and examined this appficalion ar.d know Ihe same lo be lnie and <br />correcL All piovisions o//aws and orrlinances go� �ming fhis fype ol wor(c will he comple�ed <br />ivhelher specilie�l he�ein o� noL The g�anfin,� ol a permif does nol p�esume (o give aufhonty fo <br />violafe orcanr.el Ihe provisions o( any ofhe� s�ate or/ocal law regulafing consfruc!ion or Ihe <br />perlormance o/cons(mction. Tlraf I am aufho,izr.d Gy fhe owner a/ Ihis properiy lo perform llir, <br />wo�k for �vhrch applicafion is made and I compty wilh Ihe Slale Coohaclors! aw iB.27 RCW aqd <br />296.200 WAC. <br />_���, � ��. ��,e� � �-1—�y_ _ <br />� �----- <br />Signalure Daie <br />FEE <br />� 1' l� <br />PERMITI! 1 <br />E J�G�-U�(,� <br />