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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREl-f, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa org <br /> i � 15�� —tio5 I <br /> � �y3 ELm 5�. � _�-� --'S <br /> PROJECT ADDRESS <br /> I �IN(q �7/�S <br /> Ovmer �,�a�i andress C�:y Staic2�p Phone <br /> ��U7} /��r.5 . <br /> ' Tenanl Ida�l Adaress G!y Slate2�p Pnone <br /> i ,�y �tzs-3��-�zsq <br /> , �OCQm CFPL/Nh INI. /9/L �GEKP� fNJE•Sr� l7A ���e�" c�A . 4sao� <br /> �, Eleev��r�l Contractor 1.'ad qddress cny otaie�Lp Phone <br /> 6EAcoGi9 �1`tD� oS3Co Ss <br /> � State License Namber�reqwretl) City of Everetl Bcs�ness License Number(requ�red� <br /> �90� .o 0 <br /> Proposed Use of Butld�ng CCntract PnoC O(VJotkJ7N01K'@CQIISlIGco7`�• <br /> I�� (�I FC- -yz��3l�-Sz59 � <br /> i Square Foolage pf res�dent�al new consiructwn,remodel or adddion) Contact Person/Contad Numbed[mad <br /> I y5 'I <br /> � Number ol devices Uf lo�v voltage) <br /> i <br /> DescnpUon of Work to Be Done. ����GQ �r(LC {�C�M /�NEL ,� QQU(��S I <br /> � <br /> -------- -- <br /> I —.—__--- — �I <br /> I FEE � I <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> a�� °- � <br /> ; I he�eby crrtity that I havo road and erammed Ih�s app6cafion and Mnow�he same fo be true anU _ ____ <br /> i cor�oct All prov�s�ons ol/aws and ordurances govemmg Ihis type ol work�vdl bo complefed - - <br /> j �vhelhor specified hermn or not The granfing o(a pemut doos nof p�esume fo grve aufhonty to PERP1iTk ; <br /> v�olate or cance/the provisions ol any ofher sfate oi local la�v�gulafing conshucfion or tho ;' <br /> � pcAormance o/consVuc6on Thaf I am aufhonaed by fho o�vner o/Ilus property fo perlonn the E '�O Z''�Q� ��I <br /> ' work for�vhich app6cation�s made and 1 comply with the Sfa(o Confraclors La�v 18 27 RCW and <br /> � 296 700 WAC. <br /> — ���J <br /> Signaium Da e <br /> __ ___—_��� —_ __— —_.._.__ —.--� <br />