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ELECTRICAL PEF�MIT APPL�CATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetiwa.org <br />22� SuJ ���rT /'�,� %v�/ <br />PROJECTADDRESS <br />Owner <br />� n-/.4x 3� <br />Mail Address <br />Cify <br />SlalelZip <br />� �IO ���f <br />G i �87..057 <br />Cl, <br />Phane <br />I�GbYt.✓rGL 3%�% /�6�9'z�� S�TfL'P �i� <br />Te�anl MaBAddress Ciry SlalelZip Phone <br />�tl�.�.. /,r�,�,,�- 5�,� 6��' 2i6 sT sw�/�� ��,�ETa� �/� ��3 <br />Eleclrical CoNfaclor Mail Address City Stalel?ip �� � Phone„� <br />�1%CsTt�wS' 99��F <br />Stale License Number <br />� �'T/4'/ � <br />Proposed Use of Building <br />Square Footage (If residenlial new construclion, remodel or addition) <br />SZ <br />Numher of devices (If low vollage) <br />� .'7 L 2S � <br />Conlract Price of Work <br />//if�✓ �J�K�/ <br />Conlact Person (Plan Review) <br />Description of Work to Be Done: �67°�P'�� (%D/CE �- DR-7� C�L/'�G-- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhaf I have read and examined fhis application and know the same fo be (rue and <br />cor�ect. All provisions of laws and ordinantes goveming Ihis type o( woik will6e completed <br />whelher speciped herein ornoL The granting oJa permif does nof presume lo give au�honfy �o <br />viola(e or cancel the provisions ol any ofher slate or focal law regulating constroclion o� (he <br />pedormance ofconstmcfion. That I am aufhonzed by the ownerof this propeAylo peAorm fhe <br />wor'�c tor which applicafion is made and 1 comply wilh fhe Stale Con(�acfors Law 1 B.27 RCW and <br />296.200 WAC. l <br />FEE <br />�d•0� <br />PERMITN <br />E I �� �-D�' <br />