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�LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVFRETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />��}a Z s� ���tf- Nl.�,��. W <br />PROJECT ADDRESS <br />�—ll —I�f r7 <br />Ciypi_o�K <br />�v<..z�4- �(.LC' �8�j� V�cn V..swmu.n i�ve �.5�,� .S'/D T�v,�e�Cf� �iZ61Z <br />Owner Mail Address City StatelZip Phone <br />��c�.rs G-��-f3 l�oZ 5� ��.t�N�,�1 U�-r ��I��w�- Hg2aY, <br />Tenant Mail Address City State/Zip Phone <br />� �i1 Savi'� �n�,;:.�� � . <br />ElecUical Conlractor Mail Address <br />Fve�c�n.�y�Zsa <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construclion, remodel or addition) <br />2 <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />�� � <br />�.-�[.r �t Q � 0 � <br />Sla�elZip <br />��IS,� <br />CoNract Price oF Work <br />�x 6� l�h�.� <br />Conlact Person (Plan Review) <br />Phone <br />�" �� \ <br />� ' : �c�Y163'i�� GL�t � �Y�- � � <br />! hereby cerlily thal l have read and examined this applicalion and know fhe same to b� frue and <br />correct. All provisions o! laws and ordinances goveming lhis type ol work will be compleled <br />whefher speci6ed herein or nol. Tbe granling of a permif does not presume fo give aufhonty fo <br />violafe or cancel lhe provisions ol any other sfafc or IocaUaw regulaling consfruclion or fhe <br />pe�/ormance oI conslnictron. Thal 1 am aulhorized by fhe owner o( lhis property to perlonn fhe <br />wo�k /or which application is made and 1 comply wifh the Sfafe Confractors Law 78.27 RCW and <br />296.200 W�1C. <br />eev�seo a�ai� <br />FEE <br />��� <br />PERMIT# <br />E /�0�'lI3`� <br />