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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-BB10 - FAX 425-257-8857 — vnrow.everettwa.org <br />PROJECT ADDRESS <br />Owner Mail Address <br />_ <br />hM� lynaR f <br />City <br />_ l <br />(l��P`�\�\/�����f��4� <br />M `- <br />State2ip <br />1 <br />r�U <br />Phone <br />y� •-NOD — <br />-0Inn-.'91� <br />Tenant Mail Address <br />City <br />FkP(-Q.!Z't- <br />Stalebp <br />Phone <br />4 <br />C`4C-bC-� ��_ LC'NiiA 1�1��'5�)tV Q <br />w <br />1 <br />Qi `-%,gZ <br />�q(S2TY1/ <br />�5 �j•nant� <br />Electrical Contractor Mail Address <br />City <br />State/Zip <br />Phone <br />I <br />L) <br />k n�)tQ <br />M <br />.()� <br />_07 <br />State License Number <br />Contract Price of Work <br />�MQcC\�C\ <br />Proposed Use of Building <br />) tl ,fit <br />Square Footage (If residet�new`construction, remodel or addition) <br />1 <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contact Person (Plan Review) <br />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of law: and ordinances goveming this type of work will be completed <br />whether specified herein ornot. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RC W and <br />296.200 WAG. <br />REVISEDIWIJ <br />FEE <br />A <br />PERMIT# <br />E t310-aS� <br />