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ELECTRICAL PERMIT APPLICATION <br />rITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — v�rriw.everettwa.org <br />�'��� Y���� � <br />PROJECT ADDRESS <br />Owner <br />� IC.y ne r � ) <br />� <br />tAa�l Address <br />Cdy <br />StatNLp <br />Phonc <br />Tenant tAatlAddress Gry State2�p Pnone <br />1�3 �r.le�T�` � Z�ZS" 1 ��" d � S� �.seN.tr �1 �1�8 �� .6e <br />ElectricalConlractor Mailnddress Cuy State�Zip Pnone <br />D3 �-� 3 ��t S6 D �i <br />Slate Lice�se Number (requtred) <br />�L �i P'� <br />Proposed se of Building <br />� <br />Square Footage Qf residential new construcuon, remodel or addition) <br />� <br />Num6er ol devices (If low voltage) <br />�� � � <br />City o( Everett Bus�ness License Number (reqwred) <br />I� <br />CoNract Price of Work <br />�A�� r���rz <br />Contact Persen/Contact NumbedEmail <br />`1 Z� �7 � . 60�� <br />p A.�e Q 03 i��e �T � c. • �� <br />Description of Work to Oe Done ��� �v �� �-S ��r ��'' �� ��� — <br />�L� <br />�� <br />� <br />�. C � I�t?i� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />� <br />1 heieby certily fhat I have read anU examined tl�is applicafion and know the same lo be true and <br />correcf. All p�ovisions o/lav✓s and oidinances goveming fhrs (ype ol work �vill Ue completed <br />whether specified herein or noL The grantuig oI a permif da^s not presume to give authonty to <br />violate or cancel the provisions o! any ofher state or local law re9ulafing consWction or Ihe <br />perfonrance ol construction. Thal 1 am authorized 6y fhe owner ol fhis property to peAami Ihe <br />n�o�fc lor �vhich applicafi� � is made and 1 compty wifh fhe Sfafe Con(ractors Lar� 18 27 RCW anU <br />296 200 Vt�AC. n ' \ <br />ni <br />l' <br />FE[ l <br />�� �� I <br />, <br />PERMIT/r <br />E i�b 2 -o �f3 <br />