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--�-�!`�,-I u �3 � J�^ - <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVEFtETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, V�'A 98201 <br />425-257-8810 - FAX 425-257-8857 — �^nvw.evereltwa.org <br />� l�5 J" G rl/� e4� !-\V{– — <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />� Mail Address <br />Mail A�i�ress <br />I�n.� �U'\C.. ��3� �v �Jt�:•� <br />Cort�actof Mail P.ddress <br />�l � ������ <br />Staie Llcense Number (required) <br />Proposed Use o( Building <br />Square Foolage Qf residential new construction, remodel or addition) <br />Number o( devices Qf low vollage) <br />Descrip�ion of Work to Be Done: ""�'`� (/ O� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry <br />Ciry <br />City <br />��,�o-�.-o3y i <br />� ao -► s <br />w����3 4z5 7so g�° <br />Slat^1Zip Phane <br />StalelZip <br />StatelZip <br />F�icne <br />Phone <br />C��-1 � 21(0 <br />Cily of Everett �usiness License Number (required) <br />Coniract Price o( Work <br />Conlacl PersoniConfac� NumbedEmail <br />�1��� p�� <br />I here6y certily fhat I have mad and examined !'ris applicalion and k.vow the same lo be tnie and <br />correcL All provisions of la�vs and ordinances goveming this fype ol work will be complefed <br />v�hetherspecifred he�ein ornoC The g��nling of a permit docs nof presuma fo give au!honty fo <br />violate or cancel the provisions o/any other state orlocallaw �egWating consfruclion o� fhe <br />perfomiance o(consfruction. 7hat 1 am authonzed by (1ie owner ol tliis properiy fo per/orm Iho <br />riork /or which applicatign'�S made and / coriply with the Sfale Contractors Law 18.27 RCW and <br />296200 WAC. „ / / �q <br />aenseo osnv�o ia <br />f-EE D <br />I � °� <br />PERMIT� , <br />E �I�OZ-d3� <br />