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ELECTRICAL PERMIT �4PPLlCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRGET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />', l�faZ sE F��eiel� M4// � <br />I PROJECT ADDRESS <br />i <br />IC�vner r.ta�,lAdaress <br />��U <br />lenant <br />1.1ai1 ACdress <br />2�'vi�2_r� � le �-(�'i �l� <br />[leclrieal CoMractor hlad Address <br />Gry <br />r;;y <br />N� pa� CN �/.�hco�.— <br />City <br />��'✓ieel 9y2Dg ,_ <br />State License �umber (required) <br />Proposed Us� of Building <br />Square Fooiage Qf residential nem consiruGion, remodel or addition) <br />�Vumber of devices Q( low voilaye) <br />Descriplion of �Vork �o Qe Done: <br />o✓P�l,ra� 1���,f5 <br />SlalelZip <br />State7_ip <br />i,✓f} i P 6 �Z <br />SlalelLp <br />Phone <br />Phene <br />;03 7yo z Z5, <br />P�one <br />a�lied �t z z <br />City of Everetl Busi e s Lice e Nu ber (required) <br />���� o 00 <br />Contract Price of Work <br />Contact Person/Contact NumbeUEmad <br />J�ca� P«�eIS � ��/o�al� co5�w,��s, /2����_ <br />Q,, .t' ��/d �vA �, k �, y (, �5 • <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I I�� UO <br />I hcreby cerfily that ! have rcad and examined Ihis applrcafion and knou� Ihe same fo be tnie and <br />conecL All pravisions o(la�vs and oniinances goveming lhis type o/ �•.ork �•�ill be conrpleted <br />�vhefher specified herein or noL The granting o/ a peimif does not presumc to give authoiily to PERMITr <br />violate or canccl the provisions o(any ofherstale or local law regulating conslruclion or lhe <br />pedonnance ol cons(nicfion. That 1 anr aufhonzed by fhe o�•:ner o! fhis properfy to peAorm the E I 5 0 2- � 3 <br />�vork /or which applicafion is made and 1 comply ��ilh (he Sfate ConVactors La�v 1827 RCW and <br />296.200 WAC. � �� / / <br />��li 1� z �3/� <br />, n��o <br />r.tv�sen o� s:. o u <br />