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� <br /> ELECTRIGAL PERMIT APPLICATION <br /> CITY OF E'�ERETT PERMIT SERVICES <br /> 3200 CE�7AR STREET, EVERETT, WA 98201 <br /> 425-257-881L' - FAX425-257-8857 -�wnv.everetlwa.org <br /> �l �(�► ��►� �a� <br /> ���- c.e.r—n-L—�� <br /> � <br /> PROJECT ADDRESS <br /> Owner Ma�l Atltlress Gy StatelZip Phone <br /> C 1a��•�un�nl- �f \\�,.uv �il`z �VGryfGe� W�. � l`ven.�1- lrsJ� <br /> Tenant t �I Atltlress Gry S�aleZp Phone <br /> U� Ete� ;-��� 3� c W� �ti-,.ti(-� A� � �5 t �.�en-1- ws� �t8d�a ,�S 3-��a-1 �S- <br /> Eiectncai Conlractor Ma�i nddress cdy StalelLp anone <br /> EC CU�..S �,iv1=1�3 P1= ��9 �U� <br /> State License Number(required) City of Everett Business License Number(reqwred) <br /> Co,n�n-�er� ��.� �500 . oc� <br /> Proposed Use of Bwlding Contract Price of Work <br /> �uS4•v� (,�ro•� ��� <br /> aS3 -Q7a-lau� �S;Y1vlpOl)cneLCL,�-�i •YIQ,+ <br /> Square Footage(If res�tlenhal new construcUon, rem�del or addition) Contact Person/Con�act Num eriEmail <br /> Number oF devices(If low voltage) <br /> Description of Work to Be Done. ( �' C��C'C. (:,�.4f�M � G/��-Cv\ rf,y�G� CUnY��C:�-��. __ <br /> �l�v v 1 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � 57� ✓O <br /> 1 hereby cert�fy thaf/have�ead and examined this application and know the same to be t�ue and <br /> conect All prov�sions o/laws and ordinances govemmg fhis type oI�vork wdl be completed <br /> whelher speci6ed herein or not. ihc granting ol a permit does nof presume fo g�ve aufhorily to PERMIT« <br /> violate or cancei the prows�ons ol any other slate or local law re9ulaling conshuchon or the ^ � J O`� ` � <br /> peAo�mance ol constructioa That I am autboiized by fhe o�:ner o/fhis property to peAo�m fhe t l� 5 O <br /> work!or which application is made and 1 compty wrth fhe Stafe Confractors Law 78.27 P,CW and <br /> 296 200 C <br /> �_--�' S l C�/� <br /> Si�R�ture ate <br /> / <br /> REViSED OB,95?Ot+ <br /> Cc..�1, .�2 53 - 8�1 � - l�tv S -F�r P�,�,�u.n k- <br />