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S' OU pr� <br /> ELECTRICAL PERMIT AP�LICATION <br /> CITY OF EVERETT PERMIT �ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-;57-8810 - FAX 425-257-8857 — n�w�v.everettvea.org <br /> L g�5o�-0� 6 <br /> SSa l C.a l< < <br /> � �J� a -ao��s <br /> PROJECT ADDRESS <br /> �� 7�`t gG I1 <br /> ��Ct�s� �� b SS� � Ga�lc,t,c� .�� �%�i�.� � l.� `�1��� � - <br /> Owner M11ailAddress Gty S�ate2�p Phone <br /> Tenant 61ailAddress City StatelZip Pncne <br /> ��✓ �-� SnL '-r°��\ JJ '�x��J pro�0 IA,T g�-(�i �iS��- �-t�`7 IC-�i�--- <br /> Electrical Contractor Atail Address tly StatelZip Phcne <br /> ��- �-��i�1 �3� 6��� 16 <br /> State License Number(required) City of Everett Dusiness License humber(required) <br /> _ _ I <br /> IProposed Use of Building Contract Price o!Work i <br /> Square Foolage(If residentiai new construclion, remodel or addition) Conlad Person/Conlact NumbedEmail <br /> \'umber of devices Qf low vollage) <br /> Description ot�Vork lo Be Done: .�_�_ Ud `�� �— `^r�^ �' "—' <br /> FEE O <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � O <br /> �� � <br /> 1 hereby cerlily thaf I have mad and examined this application and know the same to be trt�e and <br /> cormcL All provisions of la�vs and ordinances goveming this type o!�.oik r�ilf be completed <br /> �vhefhcrspecified hercin ornof. The granling ol a pemiit does not presurne fo give aulhonty fo PERh1I'i:1 <br /> violate orcancel(he provisions of any o(her state or local lavi iegulating consfrucfion or the E � ��o L-D 3,� <br /> pedonnance o(construcfion. That 1 am authorized by the o�vner o(fhis pmperfy fo pe�fomi fhe <br /> work for�vhich application is ade and 1 comply with fhe State Contracfors Law 18 27 RCW and _ <br /> 296.200 WAC. <br /> � ' � zvl5 <br /> Si natw Date <br /> esvisr.o uaccvou <br />