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� � <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —www.everettwa.gov <br />'ZZ� S, C. EUI,fLET'T MAL� WA`� <br />PROJECT ADDRESS <br />Owner <br />Mail Adtlress <br />City <br />CI�D �'!-/zb <br />c _� 7- i5 <br />Sta1c�Z�p <br />Phonc <br />� I(ZE LIOvSE S�R S ZZ I SE Ev�n�� Mh�� l..Ry ��tJl-Ei'r I.v/� �`02��6 <br />Tenant M;�dAtltl�ess City StatclL�p Phone <br />N EW �—I F E EI.EL'i2� C 572�6 147TM Sr SE EvE2EiT wA `��Z��S �206� 7 S5� 3��% <br />Electncal Contractor �da11 Address Gty StalelZip Phone <br />N Ew LI �E g`�2 J H <br />Stale License Number (required) <br />�- (ZESTA�J�naT �N�t2 '�q Oc� <br />Praposed Use of Buitding <br />2,�95 <br />SQuare Footage (II residenUal new conswdion, remodel or addilion) <br />5 <br />Number ol devices (If low vollage) <br />Descnphon o( Work to He Done: <br />rSTAv 2A�T <br />k�.IANT I M <br />CfTY OF EVF.RETT LOCAL SALES TAX CODE IS 31D5 <br />6511'�$ <br />Ciry of Everetl Business License Number (required) <br />3(�� 000.°0 <br />Contract Price ot Work <br />Conlact Person/Conlact NumbcrlEmad <br />.�n t... T— a U I�. O iV t hJ <br />I hereby certily that I have read and examined fhis applicatron and kno�v the same fo be true and <br />correcf. All provisions of la�vs and ordinances goveming fhis type ol work will be complefed <br />whefhe� spcafied herein or noL The gran6ng oI a permd does not presume fo give aufhonty to <br />vio/afe or cancel fhe provisions ol any other sfate or local law mgulatrng construcf�on or fhe <br />perfoimance ol constructlon. That I am authonzed by fhe owner ol th�s property (o peAomi the <br />�vo.�k lor which application is made and 1 compty wrth fhe Sfafe Conmactors Law 18.27 RCW and <br />296 200 WAC. <br />. � i <br />vk <br />RlVISF0080G?O�J <br />FEE Q <br />��D, �� <br />PERMIT# <br />E 15(Y�-12o <br />