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ELECTRICAL PERII,IIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> ,� _�-6 �-� s <br /> [-�.SoS--j 4 7 <br /> � 7 I S �s����, <br /> PRO�ECT ADDRESS <br /> l-�o� ��� �- u� ��l� �ge2 � <br /> Ownef A1ailAddress City StatelZip Phone <br /> Tenan� MailAddress City Slale/Zip Phone <br /> 1 � <br /> G�—,�/IY.� �("tG �/'� �— <br /> i/ <br /> EleclncalConiraclo� MailAddress City State2ip Phone <br /> CD"^ P� � 5 �l�i � ��-/ j vt Ilv'a�sc - �rOvj� reC�t � <br /> Sta(e license Number(required) Cily o( verett Busi ess License Numher(r quired) <br /> ��� <br /> Proposed Use of Building Conlracl Price of Work <br /> �!'�� 1'��M �m�l��.�-, <br /> Square Footage Qf residential ne���conslruction, remodel or addition) Contacl Person/Contacl Number/Emad <br /> Number of devices Q(low vollage) <br /> �escription o(Work to Be Done: ` ��"'t ` • ��� � � ��^� <br /> (/15 { �Xi r�"'a� �' ' f C�'� <br /> �Q� 4C_ l��� ,!� .P,lR�7r�st <br /> FEE <br /> CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 � � ��,�� <br /> I hereby ceAily tha(I have read and examined Oiis applicafion and know the samo to be lrue and <br /> conec(. �]ll provisions o(laws and ordinances goveminy Ihis type ol work��✓ill 6e comple(ed <br /> t•�hefherspecified herein or noL The granting o(a peimif does nof presume to give authonty(o PERMIT:i <br /> violate orcancel Ihe provisions of any ofhersla(e or focallaw iegulafinq consliuclion or fhe � I e D r ^ I ' `� <br /> pedormance of conslruclion. That I am authonzed by Ihe owner o((his prope�ty fo pedomt Ihe 7 '7 �'� <br /> �vork(or which application is made and 1 comply�vifh the S(ate Contractois Law 18.27 RCW and <br /> 296.200 C. <br /> S��/�5 <br /> Date <br />