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ELECTRICAL PERMIT �,PPLICAT�QN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everethva.org <br /> 2`i�� Ful i�r) <br /> PROJECTADDRESS <br /> 1-�t� �.�' �3�s ��o�S <br /> Ownef h7ailllddress City Stale!Zip Phonc <br /> Ten2�1 MailACdress City StafelZip Phene <br /> 2 <br /> St,MMIT - �FC7f'�� 6�33 26�5-r Sr Nw S�Nwoo� wr� ��,Z-q'L 30�5�5� <br /> Electrical Coniractor MaitAddress City State/Zip Phone <br /> S�r� t�)1E1 c�oo k2 �✓�c,�o <br /> Stale License Number Contracl Price ot Work <br /> S�1` <br /> Proposed Use of Building Conlad Person (Plan Review) <br /> � � GU <br /> Square Foolage(I(residential new conslruction, remodel or addition) <br /> Number of devices (I11ow voltage) <br /> Description of Work lo Be Done: ��� N�ll.� S��. �.LO �M� S C�V1�,[ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 G/, �d <br /> � V <br /> 1 heieby certi/y fhaf I have read and examined fhis applicafion and know fhe same fo be liue and <br /> corre�t. All provisions o(la�vs and ordinances goveming tl�is fype o/wo�k will be comple(ed <br /> whefherspeci�ed he�ein ornof. The gran(ing ola pe�mif does nol presume to give autliorify to PERMIT# <br /> violate orcancel the provisions ol any othersfafe orlocallaw regulafing consWcfron orfhe � � . r�� , ��� <br /> peAormance ol conslruction. Thaf 1 am aulhonzed 6y Ihe ownerollhis propeRy fo peAorm Ihe l� <br /> work for which applicafion is made and I comply with the Sfale Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �J hci A y I Z , '1,a 1'� <br /> S nalure Dafe <br />