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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERFTT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�o SW �ve.r�e�l- M�II ��ct� �6 <br />PROJECT ADDRESS <br />Car�bQl� , F�CU�y �% � P.0 .�OX �%S% �l�i�c.vl�S � l�%%� I�J�� �. v�aE 5�a l9o"'X <br />OwnBr Pdail Atldress Cdy Statc/Zip Phone <br />��S-�af�e .2o sw Evereff Mull �..wt� G�v2��r Ef- Wf1 1`�aoy <br />Tenant ��tail ACdress C�1y State2�p Phone <br />Si�, Sys�e,�s �+{a o � <br />Conlractor htail Address <br />����XNc e 8 s L3 <br />State L�cense Number (reqwred) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or adCition) <br />Number of devices (If low voltage) <br />Descriphon of Work lo Be Done: <br />CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br />Gty <br />3 <br />Stale/Z�p <br />Phone <br />oa �t�-86 <br />City of Everett Business License Number (required) <br />�� 0 oc <br />CoNract P�ice of Work <br />J31a,k,,, � �.�o bs <br />Contacl Person/Conlact NumbedEmail <br />11eW �errn � ks Q herry s� 9��s-ys f-�,u s <br />I he�eby certily thal I have read and examined fhis applicalion and know the same fo be Irue and <br />conecf. All provisions ol/aws and ordinances goveming (his type ol work will be compleled <br />whether speciGed herein or noL The granfing ol a permd does nof presume fo give aulhority to <br />violafe a cance/ (he provisions ol any ofher sfa(e or /ocal law regulaling consfruction or the <br />pe�fo�mance ol consVuclion. That 1 am authorized by tlie owner o/ fhis property fo peAor'm Ihe <br />�vork lor which applicalion is made and I comply wifh Ihe Stafe Confractors Law 7H27 RCW and <br />29b.200 WAC. <br />�P�,�. �.� rlla� �r� <br />Rrv�SEJ 030�?Ola <br />�� <br />FEE <br />5C��� <br />PERMIT# <br />Eiyil-��� <br />