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ELECTR�GJ�L PEf�iVllTi APPLICATION <br />CITY Of= EVERETT PERMI�' SERVICES <br />3200 I;EDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wv�rw.everettwa.org <br />_%��U c�ff-sr��> -��- <br />PRQJECT ADDRESS <br />Tenant <br />i <br />n <br />Con!raclor <br />Mail Addre>s <br />l� <br />Mail Address <br />Mail Address <br />%P,(u77`-P� �/%��� <br />State�Cicense Number <br />�OCIf`�; _Tr i(lll\G I'1���I� <br />Proposed-U�e of Building/ <br />Squaro Footage (I( residenlial new consiruction, remodel or addition) <br />Number of devices (If �ow voltage) <br />Descrip�ion of Work to Be Done: <br />City <br />State/Zip <br />�tale/Zip <br />v-�--�3 <br />��3oy�ni� <br />Phone <br />Phone <br />City Stete2ip ���,�. P�7�\` <br />s���, <br />� <br />Coniract Price of Work <br />CoNact Person (Plan Review) <br />r <br />U%%� ���=°1 �v� ,�G�%G_• i � <br />e /!/r�S�G'1�lC7C..C�� — <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriily thaf 1 have read and examined Ihis application and Nno�v the same fo Ge tn�e and <br />conacf. All provisions oflaws and oirlinances goveming this type o/ �vork will be completed <br />whether specified herein ornot The g��nting o(a peimit does not presumo to givo authoritylo <br />vielate orcancel the provisrons ol any otherstafe orlocal law regulating construction orthe <br />pedonnance o/construction. Thaf 1 am aulhonzed by the o�vnero(this properfy fo per(onn the <br />work (or whicii appl�cnf'on is made and 1 cornpty wilh the Sfate Contracfors Law 18.27 RCW and <br />296.200 WAC.,. � > � <br />,.y ' <br />� ' i Sig <br />�, <br />RFVISED Y10/13 <br />�-�_ / t_ <br />/ <br />FEE <br />���Z 50 <br />PERMIT# <br />E ►�v4-o�� <br />