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� • -- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> Z �,��,im I�i�r.t� � re j-�rP�t�_Wf�� �'S2o 3 <br /> PROJECT ADDRESS <br /> (�rz�) <br /> �v,�he`�c. S�tin..,� � 2I � � C�lu��'c� f1'U� �v'Zc-��`�G18z�3 2�s-lo�l7`f <br /> Owner ldailAtldress Cdy S:atelZ�p Phone <br /> I <br /> � Tenant 1.9ai1 Atldress Crty Stale2�p Phone <br /> [IeciricalContractor tAa�lAddress City Plate2�p Phone <br /> Stale License Number (requved) Cdy of Everetl Business License Number(reqwred; <br /> Proposed Use of Buildmg Contract Price of Work <br /> Square Footage(II residenUal new consirucbon, remodel or addition) Contact Person/Contact NumbedEmail li <br /> I <br /> Number ol dewces Qf lo�v voltage) <br /> I <br /> Descnption of Work to Be Done (V �lA� �����.4�1���/�rQ- (�� — <br /> �,y_V 1( 0 � _ <br /> F[[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � /� D� <br /> I l � <br /> I herehy ce�idy Niat 1 have read und examined ihis applica(ion and know(be same(o be fn�e and <br /> conecf All provisions olla�vs and ordinances govem�ng this type oI�vork�vdl be comple(ed � <br /> �:hefherspecificd herein ornoL Thc granfing o/a permf docs nof presume fo give aufhonty to P[R�4iT# I <br /> vio�afe or cancel fhe provisions ol any ofher sf.'e or loi 311a�v regula(ing construclion or fhe ^ I�D�r D� � <br /> pe�/ommnce ol consfruclion Thaf f anr aufhorced by G a owner ol fhis property to peAomi fhe t <br /> �vork!or n�hich npplica(ion is made and 1 comp i wifh th� State Confraclors La�v 18 27 RCW and <br /> 296.200 WAC � <br /> ✓/ � _ <br /> /^ � � <br /> �SignaWre � , �ate <br /> / <br /> rEvrSED a99c?o r: . I <br />