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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�� ���� �� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />5� <br />Eleclrical <br />�Fs.�Y'ro.-IC. �i I�J <br />Idail Address <br />�dail Address <br />oc <br />Mail <br />s��7r �B7�a�-I <br />State License Number (required) <br />Proposed Use of Building <br />� <br />City <br />Ci!y <br />?3o 3 ara `� ��Sw <br />Square Footage (Ii residential new construdion, remodel or addilion) <br />Number of devices Qf low vollage) <br />Description o( Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Slate2ip <br />Yds- a5`� <br />SlatelZip <br />� <br />Phone <br />17 3v <br />Phone <br />,�.fs l,� H� a o� ?so <br />StatelZip Phone <br />� 53��� <br />City of Everett Busmess License Number (required) <br />��� �� � <br />Conlract Price ot Work <br />� A�,,,.�-G� a o � Z�o � �1 <br />Contact Personl oMad NumbedEmail <br />1 hereby certify that I have read and exammed this application and kno�v the same to be true and <br />correcl. All provisions o/laws and ordinances goveming Ihis type olwork will be complefed <br />whciherspecified herein ornot The gran(ing o/a permif does not presume lo give authonty to <br />violafe orcancel the provisions ol any efh,er state orlocaf law regulafing consWction orthe <br />perlormance ol consfruction. Thaf 1 am aufhonzed by fhe owner ol fhis propeRy to peAorm !he <br />work Ior which applicafion is made and 1 comply �a-rlh Ihe State Con(raclors Law 18.27 RCW and <br />f.CV6E00C9GOGfI <br />FEE <br />� 0 06 <br />PERMIT� <br />E (�OZ-O� <br />