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� <br />� <br />ELEC�'RICAL PERMIT APPLICAT10�6 <br />CITY OF EVERFTT PERMIT SERVICES <br />3200 CEDAR STh�ET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - v✓wv✓.everettwa.org <br />��blJ( ��tG�,��n l,U�� <br />PROJECT ADURESS <br />1/+ 221i R-�mi.aNa �,�. ��e�lv�q hwn,, ln�A ' 9��2 <br />��+r.nno�n� I�.Ir%P.^CS� Go2P - P�1otUL� 36d -%'.�� '�%ZU _ <br />Ovmer <br />Address <br />City <br />State2�p <br />Phone <br />TenBn� �vta�l ACdres, Gty StatelZ�p Phorn: <br />yLs- <br />�i�.�rGau_ ��+-�-�,c ��Z� c��s���E� �.�Y-�����-9���► ���-7���3 <br />Electrical Contraclor tdad nda�ess Qry Sme.�Z�p Fhone I <br />O I <br />FI�37`C'�9` %/ P_ C� <br />late License Number <br />%��7�� L S��Q CF�� <br />Proposed Use o� Building <br />iV � <br />Square Footage (I! �esdenlial new conslruc�ion, remodel or addition) <br />� <br />ti�lF <br />Number of devices jlf low voltage) <br />DescripGon of Work lo Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />2o�rrr, <br />J�� <br />Contract Price of Work <br />jC�J7I`F%/� <br />CCntact Person (Pian Reviee�) <br />�y/ 6 0 3 <br />� G'S//��5 LrSC• <br />��%�f l3 <br />I hereby certi/y that 1 have read and exanrined fhis applica(ion and know (he same lo be t�ue and <br />correcL All prowsrons ol/a�vs and orzlinances govemmg 11us fype ol�vork �vdl be comple(ed <br />�vhefher specited herem ornoL The granGng o/ a pemu( does nof pre.;ume fo 9ive aufhonty to <br />violate or cancel the provisions olany other sfa(e or localla�v regWafing cons6uchon or the <br />perfonnance of conshuc(ion. Tl�af I am aufhonzed Gy (he o�vner oI fhis propeAy fo peAonn fhe <br />work Ior rohich application rs made and 1 comply �.vith fhe State Con(�acfors Caw 18.27 RCW anU <br />296.200 �nil„�r <br />`J <br />pEV�5E0 ]RO/1 ] <br />FEE <br />,'lJl S°. <br />PERMiT# <br />E 15�3- 003 <br />