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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 />��3 <br />� , -� £�_� c�s� �.� ���-�-I�-- <br />'I PROJECT ADDRESS <br />i <br />' � I r� -�-lc� -� <br />Owner <br />Tenant <br />:, � £G <br />Mail ACdress <br />Mail Address <br />� vch,���- <br />Cdy StatelZip <br />Ciry State/Z�p <br />Phone <br />Phone <br />La��s �1�,� t�►-� `t�d�-��is�-Pl. �tc ('r�.,ys�,I�� Wq `t�a7l <br />Electrical Contraclor Mail Address Cdy State2p Phone <br />�oRl� Sf Ls�,�C��. <br />State License Number (required) <br />� <br />,;'�s:�i�,�,�, � <br />�, P�oposed Use of 6udding <br />; Square Footagc pf residential ne�v consiruclion, remodel or addilion) <br />Number of devi�lf low vollage) <br />Descriplion of Work to Be Done <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />I� ��S <br />City of Everet Busmess License Number (required) <br />l��a�� <br />Contrect Price o( Work <br />Y;v-�99 77�g <br />C h^I S L, �c� 5 .S �y � 7�� <br />Confacl Person/Contact Numbed[mail <br />1 hereby ceridy fhaf I have rcad and examined fhis application and kno�v (he same to bc true dnd <br />correcL All provisions of laws and oidinances goveming fhis fype ol work wdl be completed <br />u•heU�er specified herein o�noL The granfing o/a permit does not presume fo give aufhonty lo <br />violafe or cancel 1he provisiais o! any other state orlocal la�: �egulating conSWction or the <br />perlomiance o/ consfiuction. That ! am authonzed by the o�vner of this property fo peAorm Ihe <br />wo�lc !or which appiicafion is made and 1 comply witb the Stafe Con(ractors Law 18 27 RCW and <br />296 200 VyAC. , <br />?�':brC CS�S : Jra <br />C.�=1/=��S y� <br />li+ l+^n� l . �o �"1 <br />FEE <br />��� <br />PERMITr <br />E ���� — � 1�� <br />ico <br />