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� <br />� <br />ELECTR��AL I���NI�i A�P�YCAT�(�i� <br />CITY OF EV�RETT PERMlT SERVIC�S <br />3200 CEDAR STREET, �VERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />Co3 � � �- � � <br />PROJECTADDRESS <br />Ovmer <br />Tenant <br />MailAddress <br />!t <br />Mail Address <br />h'�-5 �/ee`M�c 1'U' <br />Eleclrical Contraclor M��� <br />1Z5 CL� ��k c� Z 2�� <br />Slate License Number <br />Propused Use of Building <br />Square Footage Q( residenlial nevi conslruction, remodel or addifion) <br />N�ml�er of devices (If low vollage) <br />Description of Work lo Cie Done: <br />CITY OF EV[RETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />City <br />Ci�y <br />u--I k --c� <br />Ciu6�{-� <br />Sfafe/Zip <br />Slate/Zi� <br />� 1 ��,— �� L�'� <br />SIa�elZip <br />,� � �� <br />Conlract Price of Work <br />Contacl Person (Plan Revie�v) <br />I hereby cerfify fhaf I have read and examined Ihis applicafion and l�naw7he same (a 6e true and <br />conecL All p�ovisions of la�vs and ordinances �oveming Ihis fype o( work will be comp/efed <br />whefher spccificd herein ornoL The gran(ing ol a permit does not presimir, fo give authority fo <br />viola(e orcancel (he provisions ol any ofher sfale or/ocal law rer�ulalin� conslruc(ion or (he <br />perlormance o(conshucfion. That I arn aulhonzed Oy fhe owner o/ Ihis propeAy (o perfo�m (he <br />woAc lor which applicafion is made and 1 cornpty wifh fhe Sfafe Conhacfors Law 18.27 RCW and <br />29G.200 W/1C. i—'ti <br />Phone <br />Phone <br />�O <br />G59-1 <br />Phonc <br />f-EC <br />7g 5� <br />P[RMITtI <br />Ei�o��-O�U <br />