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ELECTRICAL PERMIT APPLICATION <br />501 <br />PROJECT AD ESS <br />Tenant <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />lda�l <br />Mail AEdress <br />CAy <br />Gty <br />Stale2ip <br />State2�p <br />P�onc <br />P�one <br />�ek�r.rh soi�,_t�,� '!o'!I Nerr�Q� SkA r�en�n�,�, ,,�/qau� 3,�r�v��a.s9 <br />Eleclncal Contra�tor rdad Address Gty Sta�c2p Pnone �, <br />WEsTES x 8720(� <br />Stale Ucense Num�er (reqwred) <br />►2s�de3,oe <br />Proposed Use o1 Bwlding <br />Square Foolage (If residenliai new conslruCion, remodel or adddion) <br />Number of devices (If Iow voltage) <br />Descnption of Work to Be Done: IY15lUU S O�Q�,pV� M <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />GS�lISS <br />C�ty of Everett Business License Number (requ�red) <br />sz3.�i�. w _ <br />Conlract Price of Work <br />Tosh M�IIt,-/3�v-343•1288 <br />Conlact PcrsoMContad Number/Email <br />�0� W tSfCJriSOlOtry/IL. CdH1 <br />I horeby cortily thaf 1 bave iead and examinod Ihis applicafion and know the same lo be Irue ano <br />conecf. All provisions o/la�vs and o�dmances govemmg fhis typo ot woik wdl be compleled <br />whether spea(ed horoin or not Th� granfing ol a perrnil does nof p/esume lo give aulhonty fo <br />violate or canccl the prowsrons olany other sfafe oNocal law regula(ing constnrcfion or the <br />perlormance o/ cons(ruchon. That 1 am aulhonzed by fbe owner ol fhls property lo perlorm 1he <br />work /or which applicafJQn �s made and I comply wdh Uio Sfafe Conliactors Law 18 27 RCW and <br />296200WAC. � 11/� . <br />g� i, �Zo�y. <br />AE1'i5ED0606Y��� <br />FEE <br />�,� �,Oo <br />PERMCf# <br />E I 5b� � 0�1 <br />