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ELECTRICAL PERMIT APPLICATION <br /> ' CI7"Y OF EVERETT PERMIT SEF�VICES <br /> 32W CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - ��AX 425-257-8857—www,everettwa.org <br /> tOcl io ���g����Nqy <br /> PROJECT ADDRESS � <br /> Owner Ma�l Addrass Clry State2ip p�a <br /> ��� �� Ce�i� �oti�o �v��� NA� ���t v�4�1g�2°`f 'l�3)35�-5 �f <br /> Tenant MeM nddress C�d Staterzi <br /> P Phons <br /> �S t 5'� 3S-k�. �r2 '�SVi�P� l.�il� W Ph 9�'1 `�}'�-5)1'FI _'x✓ <br /> ElecMcal Contractor � Mae Aaareas Gry State2p pt,o�e <br /> F_t.l�traWlS �11'3RE'� o �h$Ooo <br /> �tate Lleense Number(required) Ciry of Everetl Buainess�icense Number(requireEJ <br /> L19�t�1�1 UE�a�e-�C�E h�'MQ T(('J �G� � 1f�Fy'v� <br /> P etl se af ui ing Contrect Prlce of Work <br /> '�lie Au erns�em�'i wo� -�� <br /> Square Footaae(If residentlal new canstructlon,remodel or eddklon) Contect Penon/Contact NumDedEmail <br /> Number oF devlce�(If low voltage) . <br /> Desaiption of Work to Be Done: <br /> FEE <br /> CITY OF EVL'RETT LOCkI SALES 7A1(CODE IS 31p5 �(� O� I <br /> I hereby ce�tily fhef I havn reed and examined tAis appliceUon end know the same to be we end J <br /> correct. Ail p�OHsio�s oIlew�end obinances goveming Uris ype of work will he eompleted � <br /> ' whether epeeified harein or not 1'he gianfing oI e pertnit dces not prosume fo gr�e authoAty fo �ERMIf# <br /> , ro/ate or cancol tho provisions ol any other stete or local faw reyuleting conatrucUon or the � <br /> . performance ol consbvcUOn. That!em aufhorized by the owner of this propoAy ta per/orm tAe /(.f!�� D�� <br /> wortc Iw wh.ich applicedon is mede and!rnmpJy wiM Ne State Confractors Law 18.27 RCW aml l <br /> 2BF.200 WA <br /> nat:�ro `� a ''y� <br /> �rvmosoa2oi� � . <br /> � <br />