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, • � __ � <br /> � <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - wwv✓.evereltwa.org <br /> ��/?_f'�Y2e{�I <br /> �� � C� .� �-�_;���= way _ <br /> � i PROJECT ADDRESS �4�_ <br /> I �o� �� ��� �z c�r�, � ��v� Nr �.��T��i 1�U� �iBUS� �2s� -�4��� <br /> IOvmO� N:ail Address City Slate/Z�p Phone <br /> In/1n {ilroc C �I/In�/L <br /> Tenant tvla�iAddress C+ty State�Zip Phone <br /> OWv1�r � <br /> EletlricalConlracloC l�iailAddress Ciry State2�p Phone I <br /> State License Number(req�:ired) Ciry of Everetl Business License Number(required) <br /> i <br /> �2Pt�� �50� <br /> IProposed Use of Building Conlract Price of Work <br /> �n i �� S� �I�A L� �425)�4�i=14�1 s _ <br /> Square Footaye (If resideniial new construction, remodel or add�lion) Contact Person ontacl Mumber/Email <br /> P��UItGL(,I.S ((� f���'kv�l'N,�l,�� ��%t� <br /> �� <br /> Number of devices (If low vollage) <br /> � --! <br /> Description of Work�o �e Done: �0��� � � ` ��j� v U n rne�� - -_— <br /> FFE <br /> CITY OF EVER[TT LOCAL SALES TAX CODE IS 3105 �OG� <br /> I hereby certily thaf I have read and examined this applica(ion and know fhe same lo be(n�e and <br /> correc(. llll provisions o/la�vs and ordinances goveming this fype ol�a�ork�vill be complefed <br /> ivhe(her speci�ed herein or noL The granfing ol a permi(does not presume fo give authonty to PERMITr <br /> violate orcancel the provisions o/any ofhersfate orlocalla�v re9olafing consl�uction orfhe � I � 1 f _ I �� <br /> performance o/consfruction. Thaf!am aufhonzed by fhe o�vner ol fhis property to peAonn fhe � � <br /> �vork lor which applica(ion is made and I compty with the Slafe Confraclors La�v 18.27 RCW and <br /> yng.20U WAC. <br /> �I�,�l ,��/ � � �l � l � �! <br /> Sig ure Date ' <br /> rEv�SFD o'a�5?Oid <br />