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ELEC�"RICAL PERMIT r��'I�LICATION <br />CITY OF EV�RETT PERMIT S�RVICcS <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www everettwa.org <br />1 �}oy <br />-,� <br />��i� ;�e�r�� ('�k11 <br />PROJECTADDRESS <br />Owner Mail Address <br />Tenanf ` MailAdtlress <br />i;�{,�ol��:�u �li�o � _�} �,,� ('� <br />Electrical Conlrac�or � Mail Address <br />-�A�ZI�`,P � `d��'� {�1�� <br />S!ate License Number <br />����� <br />Proposed Use of Building <br />��� <br />Square Footage (I( residential new construclion, remodel or additi�n) <br />�� <br />IJumber of devices (!f low vol�age) <br />Description of Work to 8e Done: <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />Ci�y <br />State/Zip <br />SlalelZip <br />State/Zip <br />� _� p �i 3 <br />C13o6-0�(9 <br />Phona <br />� <br />Phone <br />C` � �� <br />, <br />Phone <br />�c <br />Conh,ct Pr�f Work <br />'\cd� �. �.vnsi- <br />Contact Person (Plan Review) <br />I hereby certi(� that 1 have read and examined this application and kno�v the snme to Ge oue and <br />correcL All prov'sions o(laws and ordinances goveming this t}�ps o/work will be complered <br />�s�hether speci(ied hereirl or not The granting o(a pem�i! does not presume to givn aidhority to <br />vioiale or cancel lhc- provisions ol any�ather state crlocal law regulating consWction or the <br />perfomiance ol construc(ion. That 1'am authonzed by the o�:nercf fhis property to perform the <br />�•✓ork lor which applicetlon is made and 1 comply with the State Cor.fraclors Law 18.27 RCW and <br />296.200V}�AC:�" '� ��"� j' -j- <br />' � ' % ( i�— �� �3 <br />— --�%��� �� ��� <br />i t <br />RGVISED 320/13 <br />FEE <br />�� �� J <br />PERMIT# <br />E 130� - U` f� <br />