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0 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa org <br />I �toz S� �✓G✓�tt W�� <br />�. <br />PROJECT ADDRESS <br />liver �.a�Q I4�Z <br />�E EJQ-1RM V�� Via�v t( <br />Owner Mail Address) <br />City State'Lp Pjholnf <br />` A <br />100 IjjaQ 4 <br />Tenant Mail Address <br />City State/ Phone <br />GUCLA I,nM S)0C\1IG� <br />P.(� P��x �317�6 � �19j& `�gl <br />Electrical C tractor Mail Address <br />City StatelZip Phone <br />�y <br />G` ss� b7— <br />StateLicense v11mber <br />Contract Price of Work <br />e of Building <br />Proposed Use <br />Contact Person (Plan Review) <br />% <br />.tj / Pc <br />Square Footage (If residential new construction, remodel or addition) <br />A <br />' <br />Nu� f devices (If low vo lage) <br />Description of Work to Be Done: <br />FEE —� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 vb DD —� <br />I hereby certify that I have read and examined this application and know the same to be (rue and <br />correct. All provisions of laws and ordinances governing this type of work will be completed — - <br />whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# /� violate or cancel the provisions of any other state or local law regulating construction or the E 1 3b I <br />performance of constmction. That I am authorized by the owner of this property to perform the V <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />K <br />