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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 — vwvw.everetiwa.org <br />S --� '�� <br />� � �o S—+g� <br />�1,� 30 � c ,���t �ti w-� <br />PROJECT ADDRESS <br />Tenant <br />�9� lcn1S <br />Eledri;ai Contrador <br />�C8 3a <br />Mall Adtlmss <br />Mail Adtlress <br />Mail Address <br />��CC��c SlGI �� <br />State License Number <br />�-� �--- <br />Proposed U e o( Buitdin9 <br />Cily <br />Ciry <br />.� ��t.,.r'S, C✓. O <br />Ciry <br />SS�are Footage (If rnsidential new construction, remodel or addition) <br />Number of devices (if low voltage) <br />Desctiption of WoM to Be Done: <br />�� <br />CiTY OF EVEREfT LOCAL SALES TAX CODE IS 5105 <br />s - <br />� �.q����r yzs- <br />Statc2ip <br />StatrJZip <br />�,^a G.I�, ��'S/7 �6� <br />SlalelLip <br />/8�p. o-O <br />Cont2cl Price of Work <br />,T�d � ��.Ll��, <br />Contad Person (Plan Review) <br />1 heiEby certily fhal 1 heve redA dnU exantined Iliis applica(ion and knot•� !he same fo 6e fnie and <br />correcl All provisions ollaws and ordinances govemin9 fhis lype ol woik will be cornplr.led <br />whelher specdled herein or not The ,ryranGn9 0l a perrud docs not piesume fo 9We aufhonty lo <br />viol. fe or cancel fhe provisions ol any olher slafe or local la�v rCgulalin9 cons�n�clion or fhe <br />perfomrancc o! consfruc(ion. Tha! i aui aulhorized by lhr. owner oI this propcAy fo pedomr fhc <br />wo�k !or �vh�ch upplicalion is niade and 1 comply wdb fhe Slate Confracfors Lav+ 78.27 RCW and <br />�os �an war. <br />FEVISEOYlN�] <br />PAone <br />Phone <br />Phone <br />� <br />�1�,(jo <br />PB�MIT# <br />E I�oS- I�I <br />