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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />,7 la S�/a% L�.LeQe� �o_\� l.�.a_�a �t_J� JLQ �, (1J�-� <br />PROJECT ADDRESS <br />i Owner <br />Tenant <br />Mail Atldress <br />Mail Atltlress <br />� LVS -� ti� r• �n . P��,w � 4 <br />Eieancal <br />fdail Address <br />� �o� vo �s a�s-� <br />I State License Number <br />i �e�� 1 <br />Proposed Use of pwlding <br />; _ I �n[7 �a �+ <br />� Square Footage (If r ident�al ne�v construction. remodel or atldition) <br />Gly <br />r�iy <br />Sta�elZip <br />Slatc/Zip <br />State/Zip <br />�'zioo��o <br />Contred Pnce of Work <br />Contact Person (Plan Rev�ew) <br />Number ot dewces pt lov+ voltage) �q <br />�`\t5�� J �n1' 1- �/� 1 <br />Descr�ption of VJark to Be Done: �R �CA`�- 1-�'0�� Y�Y� Y]QS --1�f"� G��'i�l �S <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eby certily fhat 1 have iead and examined fhis applico(ion and kno�v fhe same (o be We and <br />correcL All provisions ollaws and ordinances goveming Ihls type o( work will 6e wmplefed <br />whelher specified herein or nol. The granting ol a permi( Uoes not preswne fo give aufhonty (o <br />v�nlate orcancel fhe prowsions o7any ofhersfate orlocal lavi regulating construcfinn orfhe <br />pedonnance of consWclion. Tha( I am aufho�izeU by fhe owner ollhis properiy lo pedomi Ibe <br />work lor which application is made and I compty wi(h fhe Stafe Confracfors Law i8.27 RCW and <br />296200 WAC. <br />r.Fv,s! o �^,ri.; <br />Pnonc <br />Phone <br />Phone <br />FEE <br />iDS-S� <br />PERMITtt <br />E1�0�—a39 <br />