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ELE�TRICAL PCRMIT 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 />�.01 l�fln�kVY.rkv �� <br />PROJECT ADDRESS <br />Owncr <br />Mail Addross <br />City <br />�� ��r�3 _ <br />Slate/Zip Phono <br />.�r�r� •335 �v��� <br />Tenant M11oil AdJress Cny Sea�c2ip Phone <br />�L ( l�• .�.nc 4.C,11� . �1�UU �,�.YN�.Of. � \�L4.1'1...1 �w11� �All� <br />Muil Address <br />N���S� c� M.� _ <br />State License Number <br />(�� n�anLcn,� <br />Proposc�d Use of uilding <br />��k�lL�� y,�n� <br />Square Pootage Qf residential new consWctinn, remodel or adddion) <br />Number of devices (If low voltage) <br />Oescription of Work lo Be �ono: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry Stotc2iP pZ,O(� � Q}qYl� � <br />�?IlI I(o <br />Contraci Pncc of Woik <br />�� a� <br />Canlact Person (Plan Reviow) <br />I hr.reby ceRily tha( I have iead ond examined this apolicafion andlmav Ihe same to be fn�e and <br />coRect All provisions of laws and orUinances govemin9lhis typo ol �anrk will Ge complefed <br />:vhether sPecified he�ein or nol. The granting ol a permif does no! pmsurne to yive aufhonty fo <br />��iolate or cancel the provisions ol �my ofher s(afe or local law mgulatiny constnrctmn or ihe <br />peAommnce o/consfn�ction. ThaU am aufhonzed by (he owner o/ Ihis property fo pedonn the <br />�:ork (or �vhich appfication is mado a�d 1 ccrnply wifh Il�le Contractors Law 18.27 RCW and <br />296200 WAC. � � � <br />/C'Vi ;EU Cv iu'U <br />FEE <br />��-�� <br />P[RMITti <br />E 1 �02 � ( (c� <br />