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ELEGTRICAL PERMIT APPLICATIO�i <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEOAR S7REET, EVERETT, WA 982U1 <br />425-257-8810 - FAX 425-257-8857 — �vww.everettwa.org <br />� 7D 5� .�. v-«'�r i��e�,Yl i,� ��--' . O� �-� <br />PROJECT ADDRESS <br />Oerner <br />Tenant <br />Eleclrical <br />�LS-_� <br />Idatl Address <br />P.taii Address <br />1h1a�1 AdCr 5s <br />(' t�I-�J �� � C� 7� I� i <br />Stale LicenT Number (reqmre�— <br />��f� <br />Propos�ed sc of �wldmc� <br />Square Footage p( residen�ial new construdion, remodel or addilion) <br />Number of devices Qf low vollage) <br />DescGption o( Work lo Be Done <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />�E.�� �- <br />City <br />C�ty <br />� ���fL <br />City <br />C-��04`��l <br />g-- a7 � �v <br />Jr3 <br />State2�p <br />Stale/Z�p <br />� ��I� <br />Phone <br />S S � � zy <br />Phone <br />�,�,� �S 07 <br />Phone <br />City of Everett Business License Number (required) <br />Con�ac! Price of ork <br />� n�� ��;� � <br />Contacl Person/Contac NumherlEma�l <br />1 he�eby ceRi(y IYat I have raad and examined this applicafion and 1<no�v the same to be We and <br />correct. All provisions o//aws and ordinances governing fhis fype ol �vork will6e completeU <br />�vhefhcr specdied herein or noL The gran(inp ol a pemiif does nof presume fo give aulhonty (o <br />viofa(e or cancel !he provisions o/ any ofher sfate or/ocal la�v regulafin9 consfrucfion or fhe <br />perlonnance ol consfruclion. That 1 am aufhonzed by the owner ol lhis properiy fo peAorm the <br />u�ork lor which applicafion is made and I comply,tvifh fhe Stafe Con(racfors Lmv 18.27 RCW and <br />296 200 WAC. �� <br />rewseoi�s�c:.oia <br />F[E <br />5C�°� <br />PERMIT# <br />EI�O$-lu ( <br />