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ELECTRICAL PERiVII�i" APPLICATION <br />CITY O� EVF_RETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />-7 � 2 5 E�.���,r�� �,.,�.i <br />PROJECT ADDRESS <br />C'45«,�� Pla�a Ltc j�ofla� 7`+oK3U �� �h�;o <br />Owner <br />7:t��'11 <br />Tenant <br />Mail Atldress <br />C�ry <br />Mail Addmss City <br />iv6io NE G2"`��.,G„ ��lo•s <br />Contfactor Ma•I Address <br />� PP.�oR�C$6� �3 <br />State License Number (requiretl) <br />(�1-�mr�,�� Cvt1w�� �r,i�ce �Dvilpr <br />Proaosetl Use of Building <br />Square Footage pf residential new conslruction, remodel or addition) <br />�s <br />Number of devices (If low voltage) <br />�escnption of Wark to Be Dane: <br />Ciry <br />T� ��27�j <br />Statc/Zip <br />Stale/Zip <br />�(yUS2 ? <br />State2p <br />Phone <br />Phone <br />ob•y3G•5v <br />Phone <br />U�522S <br />Ciry of Everett Business License Number (required) <br />.{� /2,docJ <br />Contract Price of Work <br />C J �tM I nP 1 I-e <br />Conta t PersonlContact NumberlEmail <br />�cn-� SP � �o cUC �4%7 �P 1.�� Cwvi, n��ia w. �/ �, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heieby certily tha! 1 have read and examined Ihis :tp�lication and know fhe same to be lrue and <br />correcl All provisions o/ laws and ordinances governing this type ol work will 6e completed <br />�vbefher specified herein or noL The granfing ol a permif does not presume fo give aufhority fo <br />violafe or cancel the provisions o/ any other state or /ocal law regulafing construction or the <br />periormance of constructron. Thaf 1 am aufhonzed by Ihe owner ol this propeRy to pedorm Ihe <br />work !or which applica(ion is made and I comply wifh fhe Sfafe ConVac(ors Law 7827 RCW and <br />296 200 WAC i <br />REVISEDOB�llN1014 <br />FEE <br />I✓ W <br />PERMIT# <br />�81�12-001 <br />