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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-25i 3857 —www.everettwa.org <br /> %�—i�—�� <br /> L iu �p_��U <br /> Co6Zg ���-� -rs-r�c� <br /> PROJECT ADDRESS <br /> �i�, �'_D�2s�-y.1 � �i�Fit�f c,��l- ��7,002,�2�� <br /> OWne� � MallAddress City State/Zip P one <br /> Tenant MadAddress Cily Slalel2ip Phone <br /> �' .,rr�..-� C^.�f��-n, LC SG,1 C� (('��-1�`" t-C_���- A.ul-,i1-ISJ L H _ c.�. 9'�i7 � CPl.e'�.�1 �I� <br /> Electrical CoNrador MallAddress City SWIeIZIp Phone <br /> �Cs_..��Tcf-��'f I��f�IL. �S��' <br /> Slalc License Number(requued) City of 6veret� Eiusiness License Number(required) <br /> r�s,o�.,-�,�-,� � q, �� <br /> Praposed Use of Huilding Contract Price of Work <br /> �`�U' O 5.�• N/v:_ /�G�!ZY/L YZS3�Z$.S2I� <br /> Square Foolage Qf resiclential new conshudion, remodel or addilion) Contact Person/Contact Number/Email <br /> Number of devices (II low voltage) <br /> Uescriplion ol Work lo Oe Done: ��� �t E.I�-,ytnE�f /�✓.17'41�. ni5-ii� ,P/�14- ?-�x�A' <br /> n r <br /> .q"<r^ir i � ?it t%7 G�.l+�— <br /> F[E <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 �r��� <br /> L/ <br /> 1 hr.reby r.eiGly fhaf I hnvr, rcad and examineU fhis applica(ion and know fhe sarne fo be froe and <br /> conecf. All provlsions o/laws and onlinances yoveming fhis type o/work will be tomplefed — <br /> whefhcr spr.r.r(r.d hr.rcin or noL The grantinq oI a pc�nit does not presume to givc aulhonly fa P[RMITlt <br /> violafe or cancel IAe piovisions ol any oU�er sfafe or local Imv�egulaling consfn�clion or the r � � � O r I �� <br /> perfonnance o(consduc(ion. That 1 am au(honzed by fhe owne�o(Ihis property fo peAomt fhe C <br /> �vork lo�which applir.alion is made�nd I r.omply wifh fhe Stafe Con6actors Law 1827 RCW and <br /> 296.200 WAC. <br /> �v r ��/ <br /> Signa ie D� <br /> F�VISFD 08N6?014 <br />