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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 />� � 5 S� �r�2 �iT �v9-� � wr� � <br />PROJECT ADDRESS <br />Ov+ner <br />�j {�Q (�UCK 5 <br />Tenant <br />����- �� <br />Eleclrical Coniraclor <br />Mail Address <br />-.�{� CO 2y o I <br />Mail Address <br />G e'(�(� �O(�I . <br />�dail Address <br />RH�vno-?-�L�j�f o t�r/ <br />Slate License Number (required) <br />� ��� S�/d P C' � � <br />Proposed Use of Building <br />! 3 �.S— <br />Square Footage (If residenlial new construclion, remode� or addition) <br />Number of devices Qf low vollage) <br />City <br />Ciry <br />City <br />State2ip Phone <br />r� � 06) � � � s�s <br />Sta e/Zip 3�o y��- �P�7 <br />Phone <br />Ot{S"78'3 <br />City of Everett Business License Number (required) <br />IT�� �O <br />3nis,acOt Price o� ork Z�d <br />�' �P3 � <br />ln�w-a,�c sP��,� <br />Contaci Personl cl Numb d ail <br />V�wfZ�c-S(��H�Wit� �IC, ec <br />Descrip�ion of Work to Be Done: l� V��1�%yL �� ]�` E`� ( 5 i ��i/G S��v �%�s �fi�r <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily tha� I havc read and examined fhis application and know tbe same lo be t�ue and <br />correct All provisions ollaws and ordinances goveming this type ol �vork will be completed <br />whefher specified herein or noL The granting ol a permil does no( presume to give aufhonry fo <br />violafe or cancel fhe provisions ol any other stafe or local law regulafing construclion or fhe <br />peAoimance ol construc(ion. That I am authonzed by the o�m�. ol this property to pedorm the <br />work Ior which applrcation is made and I comply with the State Contractors La�v 18.27 RCW and <br />f.EV15EDOd9f✓IOIC <br />FEE <br />���- � <br />PERMITH <br />E i �f l2- �7� <br />