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ELECTRICAL PE�MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S�b�r3 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 / <br /> 425-257-8810 - FAX a25-257-8857 —www.everettwa.org C/3�,���� <br /> �l� G�o c.i� �r,`v-� <br /> PROJECTADDRESS <br /> � • 1/ �` �f'�VCS��IN� J O �O � <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> �'�yl� e/t,�}'�•`t- v� ¢rJ,vr� PoB�X/5`L 2 ¢�-� �/� c.•� `�f^�1! yIl P3� `1l 3 <br /> ElecUic I Conlraclor Mail Address Ciry Slate/Zip Phone <br /> ��el� r. �/� �.G � /$00 <br /> State Li ense Number Contracl Price o(Work <br /> �15 i��n �I�� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage (If residenlial new construclion, remodel or addilion) <br /> Number of devices(Ii low vollage) <br /> Description of Work to Be Done: /�G�l�� �/_ , S�L � <br /> � <br /> I FEE <br /> II CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ''1�j (���r <br /> I I hereby cerlify fhat I have read and examined this application and know the sarne to be true and <br /> co�rect. All provisions o(laws and ordinances goveming fhis fype ol�a�ork�vill be compleled <br /> whether specified herein ornoL The granfing o(a pemiit does not pmsume to give authonty fo PERMIT# <br /> violate or cnncel fhe provisions oI any other state or local law regulating construction or fhe <br /> peAormance o/constn�c(ion. Thaf 1 am aufhonzed Uy the o�vnerolthis property to perform the E �7�%�_ �� r 1 <br /> work lor�vhich applicalion is made and 1 comply wifh the Sfafe Contractors Lnw 18.27 RCW and � <br />` 296.200 WAC. <br /> s- i` - �3 <br /> Sjg aNre Dale <br /> i <br /> � xev�unvzan <br /> II---- <br />