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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />495-757-8810 - FAX 425-257-BB57—�vvw.eve rettwa.org <br />PROJECT ADDRESS <br />t L �5L5 SE l`'� Si-lc"I�[ ISUAtjo (.Ifn. <br />Owner Mail Address City StaterZip Phone <br />Tenant <br />Mail Address City <br />Mail Address City <br />��(kt�riISCGZ�i(� _ <br />Slate License Number <br />i <br />Proposed Use of Building <br />Square Footage (If residential new consW diem, remodel or addition) <br />Number of devices (If low voltage) <br />Descripbon of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1.1'� L' <br />Phone <br />statemp Phone <br />Contract Price ofWork <br />4 T1 -= lE I G� l 4 f�G�l <br />Contact Person (Plan Review) <br />G! <br />C-Vtl- G /4— y,) &4 k <br />IV�S ?40w%ti S14ol -ov1 <br />I hereby certify that 1 have read and examined this application and Imow the same to be true 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 ore permit does not presume to give authority to <br />violate or cancel the provisions ofany otherstate 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 />t%nrk for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE 50 <br />PERMIT# <br />E1304- 1L�3 <br />R£1'„-40 a-�11 J <br />