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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 - www.everettwa.org <br />31R S,t. Euex,e�,` vLi�w�-y <br />, <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />s <br />City <br />SlalelZip <br />� _��i-/�( <br />C1�lOz-�o � <br />Phone <br />5 � e s �w�.e <br />Tenant Mail Address Cily SlatelZip Phone <br />�/I�sYi SYS�k�y f729 /y3�'L Sk/ ��nau.�9 t,� �Sati yZ�sol-(�it'i7 <br />Electrica) Contractor Mail Address City Slate/Zip Phone <br />i�P-P1�, 5-�-� C�66 PR- <br />State License Number <br />�X%/L�aX, �`�s�'�-- <br />Proposed Use of Building � <br />Square Foolage (If residenlial new construction, remodel or addilion) <br />Number of devices (It low vollage) <br />� /�o� <br />Contract Price of Work <br />� � (,U e[ ;Sf <br />Contact Person (Plan Review) <br />Description of Work to Be Done; ��2la1GYL S/r-ji,. � PbLve,� �� -t�G*� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I herrby cerfily Ihat 1 have read and examined fhis applicafion and know Ihe sarne to be true and <br />correcf. All provisions of laws and ordinances goveming fhis type ol work wrll be compleied <br />whe�hcr specilied herein ornoL Tho granfing ol a pemiit does nof presume to give aufhonly fo <br />violate or cancel lhe provisions ol any olherstate orlocal faw regulafing consWc(ion or fhe <br />peAormance ol conslmcfion. That ! arn aufhonzed by the owner ollhis propeAy fo pedonn Ihe <br />work lor which applrcafion is made and 1 comply wilh Ihe Sfcfe Confrac(ors Law 18.27 RCW and <br />296.200 WAC. <br />� �..Qi�� <br />nFviseo a�ai� <br />►q <br />FEE <br />� �C� <br />PERMIT# <br />E �� 02- I(� � <br />