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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT �ERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-3057 — www.evereitwa.org <br />v��r <br />�� �� � F ��►� �w�.c, w�y <br />PROJECT ADDRESS <br />6-2,1y <br />C/Yob�S <br />Ovmer � MaJAddress City Slale2ip Phone <br />y2s <br />F�'�j0U0 S �'1f?L�°rl, �c�l� 1,1.L �Ue�' �V�'/� °102�0 3y6-7370 <br />Tenanl MailAddiess City Slale/Zip Phone <br />D 3 ��� �� 2qZS ►�g "' P� s� �„�,�� �.�s- �$� �� ��9 <br />ElectricalConlraclor MailAddress <br />173�3iz�jShO'� <br />Stale License Number <br />o c.P.� � <br />Praposed Use of Buil ' <br />� <br />Square Foolage (If residential new construction, remodel or addition) <br />� <br />Number of devices (If low vollage) <br />Ciry <br />Slale/Zip <br />i� 1 ��' <br />Contrect Price of Work <br />Contact Person (Plan Review) <br />Phone <br />� � ( <br />De�criptionofWorkloBeDone: I�YXiI�(J �' Z�� �J�%!1 �W�re u��'"`� W\ <br />� CQP ii` t.�.E ��S �n�. c,l.> •^2 I'e'iel vt-' i{- • <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />1 hereby certify that 1 have read and examined this applicafion and know fhe same lo be frue and <br />corroct. All provisions ollaws and ordinances goveming tlris type of wo�R will6e compleled <br />whelherspecified hemin ornoL The granfing o/a permif does nof presume !o give aufhonty to <br />violafe o�cancel lhe provisions ol any olherstale orfocal !aw regulafing construcfion orthe <br />pedo�mance o(construclion. That 1 am authonzed 6y lhe ownero(lhis pioperfy to perform fhe <br />work for which application is made and I comply wifh (he State Contracfors Law 18.27 RC W and <br />296.200 WAC. <br />5�,�� ?.ol �1 <br />FEE <br />7Z5� <br />PERMITN <br />Ei��� ovs <br />