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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ` '�` i� <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org � � <br /> � i �{p�-U� <br /> 3�0� coUoy k,�,�.�e .F�.df�wH 982o'i <br /> PROJECT ADDRESS <br /> E.e.eB- Na.r� t,,eYe�l- W R <br /> Owner ailAddress City State/Zip Phonr. <br /> 5aw�e <br /> Tenant Mail Address City SfatelZip Phone <br /> ���'" � � C � � W A <br /> Flectricai Co lractor Mail Address C�ty SlatelZip Phone <br /> y Av��v c�.417!_'-I <br /> State License Number(required) Cily of[vereU Ousiness License Number(required) <br /> 1{�w`A�G ��'11,.0� <br /> Idq . ����� <br /> Proposed e of Buildmg " Contracl Price of N/ork <br /> �� �ctiy�a*v�so�n �125-S�8—lSoS <br /> Squar�olage(Ii residential new conslruclion, remodel or addilion) Contact PersonlContact NumbedEmail <br /> J,�,Sh� l�cw��^`^^.°c'4rMnic� <br /> � iMc,cow, <br /> Number of devices pf low votlage) <br /> Ucscription of Work lo Be Done: 6 N1+-�^+ '�"t^R+v"`os"�s 3 Y�A�^' v � �`t� <br /> � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �1� `�O <br /> I hemGy ccrfi/y Ihaf I have read ond exomined Ihis applicnfion and knor✓fhe same fo bc frue and �J <br /> conocL All provisions ollaws and ordinanees goveming Uiis typ�ol wc�k wrll be cornpleted - <br /> whclher speci(ed hcrcin or noL Thc gr.m(ing ol a pemiil does nof prr.sume fo give oulhonfy lo PERMII�! <br /> wolalr, or caner,l Ihe provisions o/any ofher stale orlocal law regulafing consiruction or the � � !�O� � O.� , % <br /> pr.rfomi,3ncr. o/consLuc(ion. Thaf I aru aidhonzed hy the owner olthis propeity lo pedonn the ��� <br /> �vork for which applicafion is made and I comply wilh fhe Stafe Confnctors La�v 18.T.7 RCW and <br /> 29G.200 WAC. <br /> ���`— , g�al,y <br /> rrvr,m r.nt�a�:nra <br />