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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —�+nwv.everetlwa.org <br />22 � SE EVE1'--EiT IrW U.. �Y � 1`1 � <br />PROJECT ADDRESS <br />Ovrner <br />A1ail Address <br />City <br />Sta1MLp <br />Phonc <br />�i'T rlA��s 22.►�Fv��rma� w7 n� hv�� �`��� <br />Tenant A9adAddress City Stale�Lp Phonc <br />I�8 f i 5����R��[r� I��Eu.G�(��c� H�y �.c��k �A ���ia �Yzs.33o.sibo <br />EleCtritalConiraClor DAailAddress Cdy SlatelZ�p Phonc <br />r;C3l:SIS%�G`1LPQ <br />Slale License Number <br />Con�r�L� �./ S� (� t� <br />Proposed Use of Building � <br />Square Foolage Qf residenlial nee� consiruction, remodel or addition) <br />Number of devices QI iow vollage) <br />Can�rectPrice of Work <br />�i�i�Y-! i3� ` � <br />Contad Person {Plan Revie�v) <br />Descriplion of Work l0 8e Done: S A(.lr �%J� �1/ S�v� ��a�%� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereGy cerfify (hat 1 have rced and exanrined Ihis applica(ion and kno�v the same (o be Iruc and <br />correc(. All provisions olla�vs and ordinances goveming Ihis fype ofvrork �vill6e compfefed <br />�vhether specilied hemin ornot The gnnfing ot a permit does not presume to 9ive authority (o <br />violaf e or cancel fhe provisions ol an y other stafe or locaf Imv regulating consf�uclion or the <br />peAonnance ol consWcfion. Tha! I am aufhonzed by the ovner ol fhis property fo peAorm fhe <br />�vork Ior �vhich appficafion is made and ! canply wifh (he Slafe Confraclois Law 18.27 RCW and <br />FEE <br />�O� <br />PERMI � +F <br />E��lDS- 135 <br />