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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32U0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-6857 –wwv✓.everettwa.org <br /> �0�3 D���{^ ��� �v�nsi"9g��� <br /> PROJECT ADDRESS <br /> � <br /> � <br /> O��mer Ma�l Address City Slate/Lp Phone I <br /> Tenant �dail Address Ciry StateZp Phone I <br /> ., S�k � �� },:��c. �2S 39�',�,�UL �>ci� L'35'3 r'�����'JIt. ��.q�771 W7S-�s-7375 <br /> Eiectrical CoNractor G9ad Add�ess C�ty SlatelZip Phone <br /> � SiieEsE8513n� �i3�7 <br /> � State License Number (required) City of Everett Eusiness License Number(required) I <br /> � 3iSw�1 I� <br /> iProposed Use oi Building Contract Price of Work <br /> i <br /> I c,po �J�;1;,,� IoJ� � �IZS- {o� - `6��10 <br /> Square Footage Qf residential new construction, remodel or addAion) Conlact Person�Conlacl Number/Ema�i il <br /> Number of devices Qt low voltage) <br /> � <br /> IDescription of Work to Be Done: �_°t� ��� `',J�F�� u�� `�e(k� q��MS 2� o�p Z��O�o�� � <br /> I <br /> � '(c �' -�� /� <br /> I — <br /> fEE I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 `��5' O� <br /> I1 hereby certily thaf I have read and examined this application and kno�•�Ihe sarne to be f�ue and _ <br /> corroct. �II provisions o/la�vs and ortlinances goveming fhis(ype ol�vorN�vill be completed <br /> whether specified herein or nol. The granting ol a pemiit does nof presume fo give authonty lo PERh1IT« <br /> viofate orcancel fhe provisions ol any olher state orlocal la�v ngulafing constn�ction or fhe � 1�}�� � ��I , <br /> perfonnance of consfrucfion. That I am authonzed by fhe o�vner o!this property lo perfonn Ihe U "� <br /> �vork for which application is made nnd I compty�vi(h fhe Sfa(e Confractors Law 18.27 RCW and <br /> 296200 WAC <br /> �,� �— ��'/s <br /> SignaWre Datc —j <br /> FF.t�5COD6^G:OfJ _"___ � <br />