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ELECTRIC�4L PERIVIiT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857-www.everettwa.org <br />/`fOSS� �v�re�{ /Y)�l�yS�i�e%� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />StatelZip Phone <br />�er zo� [�%�rrl�ss 3�y5[S'Sfi�'A✓e -SF YYI�' 1I5� �I�edoe�i.�lA�18008 H�?S-G03•78�.1 <br />Tenanl Mail Addtess City State2�p P��e <br />Electncal Contractor Mail Address <br />CL�A��E-�9n� �m . <br />State License Number <br />l��G�./,/ _ <br />Propased Use of Building <br />y, '> �`7 S 9. � r— <br />Square Foolage ( f residential new const�i tion, remodel or additlon) <br />�� <br />Number of devices (If low voltage) <br />City <br />StalelZip Phone <br />a3�ooc� °� <br />ConVact Price of Work <br />Contact Person (Plan Review) <br />..r� �r!- lI ?" � �, ��n i G L y �.%cl.d-t,l- -F- <br />Description of Work to 6e �one: �- /l � a- ��� � — <br />V;��.o �6/�S <br />CITY OF EVERET? LOCAL SALES TAX CO�E IS 3705 <br />1 hereby certify that I have read and examined this application and know the same fo be frue and <br />:orrect. �II provisions of laws and ordinances goveming this typQ of work will be completed <br />whetherspecified herein ornof. The grantingnf a permit does not presume to 5iva au'rhority to <br />violafe or cancel the pmvisions of nny uther sta!e orlocai law regulating construc� �n or the <br />pedormance of construction. That I am authcnzed by fhe ownerof Lhis properfy;c pedorm the <br />work for which app � hon is made and I comply with the Stafe Contractors Law 1827 RCW and <br />296.200 WAC. � � � � . � <br />r.�wseo.v�miJ <br />FEE <br />jS `° <br />PERMIT# <br />E � 3c7- oso <br />