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,IuI.10. 20I5 i1:09AId <br />No.6048 P. 1/1 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - �AX425-257-8857—www.evereliwa.gov <br />I 1 w Jr �vl� 11 NIIJ����l�^ �11,\\,�1 N�i1 �VL�CJ <br />PROJECT AbbRE55 <br />Owner <br />Tenant <br />ElecVical <br />�CCnF�I"'`I�-I� A <br />Slale License Number (required) <br />�P-i(�11� �Y��e. <br />Proposed Use o( Building <br />Mal �ddress <br />Idail Pddress <br />Id311 Addf865 <br />NI� <br />Syuare Footoge (It resldenllal new construclion, remodel or adtli�on) <br />Number oT devices pf low voUage) <br />Desaiplion ot Work to Be Done: <br />ciry <br />Clty <br />SlatdZip <br />Slalc2p <br />State2lp <br />C,sb 1 �6� <br />Phono <br />Phone <br />Phonc <br />(�51���-I <br />Ciry of Everelt Dusiness License Number (required) <br />� li WV <br />Conlract Price of Work <br />�1 <br />�.►_�.����e rc�P. <br />ac Person/Con�acl NumbedEmail <br />��.y�. �� <br />S�e��in�ep�e-c-c�.com <br />3l� am���P�,�,�C� Qfl �0 1�1�� \11C��,.1� � <br />CITY OF EVERcTT LOCAL SALES TAX CODE IS 3165 <br />1 hereby ceRdy fhof 1 Aeve reod pnd examined fhis application and know fhe same to be truo and <br />co�met. All pmvislons o/laws and ordinances goveming this type of wnrk will be complefed <br />evhether spdci/iedherein or noL Thr, granting nI o permit docs nof presumc ta give aufhonty lo <br />violafe oi concel tbe provlsions nf ony ofher sfafe orlocal /aw regulating conshuction orthe <br />perlormanCe vl consbuction. Thaf I am aufhonzed by fhe owner o(fhis property fo peAorm fhe <br />woitt lor �vhich applicaUon is made and 1 comply wifb the Stalc Conhacfors Law 1@.27 RCW and <br />296.200 WAC. <br />���5�������" �k ���1 i�l�( IYl�1i�(1P(1t' ��1�-�I?iln� l nl�n�l= <br />o N�1 r1 l2 <br />F[E <br />���2,5.: <br />PERMIT# <br />E I�j01' D(�(� <br />