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ELECTRICAL PERMIT APPLICAT <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257.8810 - FAX 425-257-8857 — www.overettwo.org <br />PROJECT ADDRESS t <br />&EI N9 P ,Box 37o7,S'�1f6o <br />Owner MeilAddress city State/Zip Phone <br />Tenant Mail Addfess city 51atr�rpX� S--21Phone <br />�o� o_?�? l 198z759 <br />/�� z _ 911 L6 r54 <br />Electrical Contractor MaliAddross city Slate2ip Phone <br />e�AI,57 6G ,� - �tra�.G/].,� O� <br />Slate License Number Con il Pike of Work <br />Proposed Use of Building Contact Poison (Pion <br />Square Footage (II residential now constrvi:lion, remodel or add;tion) <br />NumGcr of devices (Illow voltage) <br />Uescdption of Work to no Done. <br />..o <br />r,ITY OF CVCRETT LOCAL SALES TAX COUL Is 3105 <br />A? I 7— <br />I hi certify that I have read and examined this opphcetlnn end know the some to bu true and I <br />rnmicl. All provisions of laws And OmInancos governing this typo of work will be complotod <br />whether specified herein or nAt The pmnting of A permd does not presume to give authority In PFRMfTJt <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />pr.An monr.A n/ rnnsrnreflnn. That I am nuthomed by the owner of this property to pudorm the _ <br />work ror which epploenflon is made And l comply with the State Contractors Law 16 27 Rr;Ly <br />296.200 WAC. <br />�=Iwi, <br />-7 <br />4�� <br />III afira /.9tt8/-gZVVfi 0.1 mo.I,i II go CU77.-g7.-r1:dS <br />