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f r o m:[i S t e r [ I e c t r i c <br />500 92.1 OJTI ❑tiOD/201q �].OE x72J P.UOJ/002 <br />ELECTRIGAL PERMI� APPL�CATION <br />CITY OF EVER�TT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425•257-8810 - FAX 425-257-8857 — ww,v.everettwa.org <br />1�-}Q� �5�� ���,rP�' (VI�II �, ��� _P_�' <br />PROJEC7 ADORESS <br />6wner <br />Tenant <br />Elecfrical Contrador <br />�►v���a���u <br />Sta;e Licenso Number <br />V��L <br />Proposed Use of �uilding <br />Mall Address <br />� <br />Mail Address <br />�II� ' <br />Mail nddress <br />/ <br />Square Foolago (If rasidonlial new construction, remodel or addilion) <br />i <br />Nur^bcr of devices Qt low vollago) <br />Doscriplion ol Work lo �e Done: <br />Ciry <br />City <br />Sta1e21p <br />Slate/2ip <br />1--6-a �f <br />C� � yol�a�`� <br />�3 D�D <br />Contract Prico of Work <br />��� -�.✓d� <br />Conlacl Person (Plan Raviuw) <br />Phone <br />Phono <br />Phonc <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I horeby certily Ifm( I heve mad and oxamined fhis opplication and know ihe somo !o be !mo and <br />corrocf. All provisions o/ laws und adinancos qoveming (lris lypo ol work will Go completod <br />whethor spocifiud hororn or noG Tho gran(ing o!a pormi( doos nof pruswne lo qive aufhonry fo <br />violnfe or cancel Ihe pmvisions ol any ofhe� sfa(e or local law mgula6ng consWcfron or (Ae <br />pedonnance o1 consWcfion. Tha( I am au(horized by fhe� ownerol fhis pioperty !o perlonn tho <br />waJc lor which npplication is mado nnd l comply wi(A Ihe Slefe Confruc(ors Low 18.27 NCW and <br />296.200 WAC. <br />aev�sen vra�� <br />FEE <br />� 3a-� o <br />PERMIT# <br />E 1�(-o(-pzo <br />