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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PEitMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 7 V 3_� � <br />425-257-8810 - FAX 425-257-8857 — www.evereitwa.org <br />�'� os S� �v�,a� n'i e�+� �a--r S-T .� D <br />PROJECTADDRESS <br />Ovmer <br />� <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />CiyD6�a� <br />Slate/Zip <br />St2!e2ip <br />Phone <br />Phone <br />�t�lFlc . sr 4�'�aEt7�X+5 �i7�i 2 E���-+PS G� h-�( � ti � �or+t�5 l.> Ft 9��' <br />Elecl�ical CoNraclo� Mail Address Ciry State2ip .Z�_�9o�ne .�g <br />��C-l�S�� 6S LlL <br />Slate License Number <br />CJ� M M 9-�Gca � <br />Proposed Use of Building <br />Square Footage (If residential new conslrudion, remodcl or addition) <br />Number of devices (I(low vollage) <br />���.� <br />Contract Price of Work <br />�l`�t� '1�'YLt—y � <`r <br />Conlact Person (Plan Review) <br />Descriplion of Work to Be Done: I F.S S� Ft-(�_ z— C-ft't'x �--' �`C S l G, r-� s <br />CI7Y OF EVcRETT LOCi+L SALES TAX CO�E IS 3105 <br />I hereby ceRify fhat I have read and examined fhis applicalion and l�now the same (o be frue and <br />correcL A/l provisions ollaws and o�dinances goveming (his type of work will be complefed <br />whefherspecilied herein ornof. The granling ol a pe�nit does nof presume to givc aufhonty to <br />vio/ate orcancellhe provisions olany otheislafe orlocallawregulating construcfion orfhe <br />performance ol construclion. That 1 am au(horized by fhe owner of fhis propeAy to peiform Ihe <br />work lor whir,l�application is made and 1 compty wilh (he Stafe Conlractors Law 18.27 RCW and <br />FEE <br />�D'� <br />PERMIT� <br />E ��k0(�-l�(� <br />