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ELECTRICAL PERMIT APPLICA�ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVtRETT. WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�o� � otit�. �a�y - F�H, wa <br />PROJECT ADDRESS <br />� <br />Owner <br />enant <br />, <br />gn/Ik �;�c{�� <br />� �� <br />Elecinca� Contractor R1atl hd�ress <br />I� "T C�Y� <br />' State L�cense Number <br />n, _�o� `1.�n� <br />CAy <br />� Ui�-� 'W 0. <br />Cny <br />kirkla�P, <br />� <br />City <br />�� UOJIAi��AI W`,�q�n\ v�)1i� <br />I Proposed Use of puilding <br />3�, 000 <br />I Square Footage (II resideMlal new construcLon, remodel or addition) <br />Number ol devices (II low voltage) <br />(��D—i� <br />C�y°z���� <br />q25-38� -g5�` <br />Statc2io Phone <br />�in.�.•415-3ee-�5�6 <br />Stale/Lp PhonC <br />State.2ip �� �hone <br />E�Y4GnL���(l nnr, <br />CoNrad Pnce ol W orY. <br />Confact Person (Plan Review) <br />! Descnplion oi Work to Be Done: w� U6�in � W L J6nJ � Vs '� '�� .UO O SF <br />. <br />�GV C, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />zsoo <br />1 hereAy ceRdy lhat I have reed and examrned Ihis applicat�on and know the same to be true and <br />correcf. All prov�sions ollaws and ordmances govemmg fhls type ol work wi116o completed <br />whether specified herein or nof. The granting ol a permif does not pmsume lo give authonry fo <br />violale or cancel the prowsions ol any olher sfate or local !aw regula(rng consfrucfron or the <br />pedomiance ol cons6uc(ion. Tbaf 1 am aufhonred by (he owner o� thrs propeRy fo pedom� tlre <br />work /or whic6 applica(ion is made and 1 comply wifh fho Sfate Confraclors Law 18.27 RCW anA <br />296 200 WAC. <br />2�,Z �q <br />R��;SE� 3M��� <br />FEE <br />�3750� <br />PERMITti <br />�1�02_ IZ�- <br />